Fluoroquinolone-Resistant and Extended-Spectrum beta-Lactamase Producing Escherichia coli Infections in Patients with Pyelonephritis, United States

David A. Talan; Sukhjit S. Takhar; Anusha Krishnadasan; Fredrick M. Abrahamian; William R. Mower; Gregory J. Moran; EMERGEncy ID Net Study Group

doi:10.3201/eid2209.160148

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Fluoroquinolone-Resistant and Extended-Spectrum beta-Lactamase Producing Escherichia coli Infections in Patients with Pyelonephritis, United States

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Fluoroquinolone-Resistant and Extended-Spectrum beta-Lactamase Producing Escherichia coli Infections in Patients with Pyelonephritis, United States

David A. Talan, Sukhjit S. Takhar, Anusha Krishnadasan, Fredrick M. Abrahamian, William R. Mower, Gregory J. Moran and EMERGEncy ID Net Study Group

Emerging infectious diseases, Vol.22(9), pp.1594-1603

09/01/2016

DOI: 10.3201/eid2209.160148

PMCID: PMC4994338

PMID: 27532362

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Abstract

For 2013-2014, we prospectively identified US adults with flank pain, temperature >= 38.0 degrees C, and a diagnosis of acute pyelonephritis, confirmed by culture. Cultures from 453 (86.9%) of 521 patients grew Escherichia colt. Among E. coli isolates from 272 patients with uncomplicated pyelonephritis and 181 with complicated pyelonephritis, prevalence of fluoroquinolone resistance across study sites was 6.3% (range by site 0.0%-23.1%) and 19.9% (0.0%-50.0%), respectively; prevalence of extended-spectrum beta-lactamase (ESBL) production was 2.6% (0.0%-8.3%) and 12.2% (0.0%-17.2%), respectively. Ten (34.5%) of 29 patients with ESBL infection reported no exposure to antimicrobial drugs, healthcare, or travel. Of the 29 patients with ESBL infection and 53 with fluoroquinolone-resistant infection, 22 (75.9%) and 24 (45.3%), respectively, were initially treated with in vitro inactive antimicrobial drugs. Prevalence of fluoroquinolone resistance exceeds treatment guideline thresholds for alternative antimicrobial drug strategies, and community-acquired ESBL-producing E. coli infection has emerged in some US communities.

Immunology

Infectious Diseases

Life Sciences & Biomedicine

Science & Technology

Details

Title: Subtitle: Fluoroquinolone-Resistant and Extended-Spectrum beta-Lactamase Producing Escherichia coli Infections in Patients with Pyelonephritis, United States
Creators: David A. Talan - Olive View-UCLA Medical Center
Sukhjit S. Takhar - Brigham & Womens Hosp, Boston, MA USA
Anusha Krishnadasan - David Geffen School of Medicine at UCLA
Fredrick M. Abrahamian - David Geffen School of Medicine at UCLA
William R. Mower - Ronald Reagan UCLA Medical Center
Gregory J. Moran - Olive View-UCLA Medical Center
EMERGEncy ID Net Study Group
Resource Type: Journal article
Publication Details: Emerging infectious diseases, Vol.22(9), pp.1594-1603
DOI: 10.3201/eid2209.160148
PMID: 27532362
PMCID: PMC4994338
NLM abbreviation: Emerg Infect Dis
ISSN: 1080-6040
eISSN: 1080-6059
Publisher: Centers Disease Control & Prevention
Number of pages: 10
Grant note: Merck Co., Inc.; Merck & Company U01CK000176 / US Centers for Disease Control and Prevention; United States Department of Health & Human Services; Centers for Disease Control & Prevention - USA
Language: English
Date published: 09/01/2016
Academic Unit: Emergency Medicine; Internal Medicine
Record Identifier: 9984297148302771

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