Fluoroquinolone Use and Seasonal Patterns of Ciprofloxacin Resistance in Community-acquired Urinary Escherichia coli in a Large Urban Center
Abstract
Urinary tract infections caused by the bacteria Escherichia coli are among the most frequently encountered infections and a common reason for antimicrobial prescriptions. Resistance to fluoroquinolone antimicrobials, and in particular ciprofloxacin, has increased in recent decades. It is intuitive that variation in resistance is driven by changes in antimicrobial use, but careful study of this association requires the use of time-series methods. We studied seasonal variation in ciprofloxacin, trimethoprim-sulfamethoxazole, and ampicillin resistance in community-acquired urinary E. coli isolates in Montreal, Quebec, Canada between April 2010 and December 2014. Using dynamic linear models, we investigated whether seasonal variation in resistance could be explained by seasonal variation in community antimicrobial use. We found a positive association between total fluoroquinolone use lagged by 1 and 2 months and the proportion of isolates resistant to ciprofloxacin. Our results suggest that resistance to ciprofloxacin is responsive to short-term variation in antimicrobial use. Thus, antimicrobial stewardship campaigns to reduce fluoroquinolone use, particularly in the winter when fluoroquinolone use is highest, are likely to be a valuable tool in the struggle against antimicrobial resistance.
Read the paper
Related studies
- Horizontal gene transfer in the human gastrointestinal tract: potential spread of antibiotic resistance genes
- Mutation supply and relative fitness shape the genotypes of ciprofloxacin-resistant Escherichia coli
- Genomic Survey of E. coli From the Bladders of Women With and Without Lower Urinary Tract Symptoms
- Characterization of cefotaxime-resistant urinary Escherichia coli from primary care in South-West England 2017–18
- Fitness cost constrains the spectrum of marR mutations in ciprofloxacin-resistant Escherichia coli
- Emerging evidence-based innovative approaches to control catheter-associated urinary tract infection: a review
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.