Risk factors of ciprofloxacin resistance in urinary Escherichia coli isolates
Abstract
BACKGROUND AND PURPOSE: Increasing rates of fluoroquinolone resistance among Escherichia coli have been reported in Taiwan and worldwide. We aimed to identify the risk factors of ciprofloxacin resistance in urinary E. coli isolates. METHODS: Patients with positive urine culture result for E. coli and resistance to ciprofloxacin between September 1, 1999 and December 31, 1999 were prospectively identified as cases, and compared with ciprofloxacin-susceptible E. coli isolates (controls). THE CASE: control ratio was 1:2. Data were collected with standardized case record forms. RESULTS: Sixty one cases and 122 controls were compared. Multivariate analysis indicated that urinary tract catheterization (odds ratio [OR] = 2.631, 95% confidence interval [CI] = 1.058-6.544; p=0.037) and prior exposure to quinolones (OR = 13.072, 95% CI = 3.367-50.75; p<0.001) were independent risk factors for ciprofloxacin resistance in urinary E. coli isolates. Compared with ciprofloxacin-susceptible E. coli isolates, ciprofloxacin-resistant E. coli isolates from urine specimens had a significantly higher rate of resistance to all other tested antimicrobial agents, except amikacin and imipenem. CONCLUSION: In patients with urinary tract infection, urinary catheterization and prior quinolone exposure are associated with a high risk of ciprofloxacin-resistant E. coli which may cause treatment failure.
How strong is the evidence?
Evidence Hub reads this as a case-control, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause.
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