caa a22 4500 606156585 CHVBK 20210128100609.0 cr unu---uuuuu 210128e20150301xx s 000 0 eng 10.1007/s10096-014-2264-y doi (NATIONALLICENCE)springer-10.1007/s10096-014-2264-y Escherichia coli antibiotic resistance in emergency departments. Do local resistance rates matter? [Elektronische Daten] [O. Grignon, E. Montassier, S. Corvec, D. Lepelletier, J.-B. Hardouin, J. Caillon, E. Batard] Ciprofloxacin and cotrimoxazole are recommended to treat uncomplicated pyelonephritis and uncomplicated cystitis, respectively, provided that local resistance rates of uropathogens do not exceed specified thresholds (10 and 20%, respectively). However, Escherichia coli resistance rates in Emergency Departments (ED) remain poorly described. Our objectives were to assess E. coli ciprofloxacin and cotrimoxazole resistance rates in EDs of a French administrative region, and to determine if resistance rates differ between EDs. This was a retrospective study of E. coli urine isolates sampled in ten EDs between 2007 and 2012. The following risk factors for resistance were tested using logistic regression: ED, sex, age, sampling year, sampling month. A total of 17,527 isolates were included. Ciprofloxacin local resistance rates (range, 5.3% [95% CI, 4.0-7.1%] to 11.7% [95% CI, 5.2-23.2%]) were ≤10% in nine EDs in 2012. Five EDs were risk factors for ciprofloxacin resistance, as were male sex, age and sampling in April or October. Cotrimoxazole local resistance rates (range, 13.3% [95% CI, 6.3-25.1%] to 20.4% [95% CI, 18.9-22.0%]) were ≤20% in seven EDs in 2012. Five EDs were risk factors for cotrimoxazole resistance, as were age, sampling between October and December, and sampling in 2011 and 2012. We found a significant variability of E. coli ciprofloxacin and cotrimoxazole resistance rates among EDs of a small region. These differences impact on the feasibility of empirical treatment of urinary tract infections with ciprofloxacin or cotrimoxazole in a given ED. Continuous local survey of antibacterial resistance in ED urinary isolates is warranted to guide antibacterial therapy of urinary tract infections. Springer-Verlag Berlin Heidelberg, 2014 Grignon O. Emergency Department, Hôtel-Dieu, Centre Hospitalier Universitaire de Nantes, 1 Place Alexis-Ricordeau, 44000, Nantes, France aut Montassier E. Emergency Department, Hôtel-Dieu, Centre Hospitalier Universitaire de Nantes, 1 Place Alexis-Ricordeau, 44000, Nantes, France aut Corvec S. EA3826 Thérapeutiques Cliniques et Expérimentales des Infections, Faculté de Médecine & Pharmacie, Université de Nantes, 1 Rue Gaston-Veil, 44000, Nantes, France aut Lepelletier D. EA3826 Thérapeutiques Cliniques et Expérimentales des Infections, Faculté de Médecine & Pharmacie, Université de Nantes, 1 Rue Gaston-Veil, 44000, Nantes, France aut Hardouin J.-B EA4275 SPHERE Biostatistics Pharmacoepidemiology and Human Science Research Team, Faculté de Médecine & Pharmacie, Université de Nantes, 1 Rue Gaston-Veil, 44000, Nantes, France aut Caillon J. EA3826 Thérapeutiques Cliniques et Expérimentales des Infections, Faculté de Médecine & Pharmacie, Université de Nantes, 1 Rue Gaston-Veil, 44000, Nantes, France aut Batard E. Emergency Department, Hôtel-Dieu, Centre Hospitalier Universitaire de Nantes, 1 Place Alexis-Ricordeau, 44000, Nantes, France aut European Journal of Clinical Microbiology & Infectious Diseases Springer Berlin Heidelberg 34/3(2015-03-01), 571-577 0934-9723 34:3<571 2015 34 10096 https://doi.org/10.1007/s10096-014-2264-y text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s10096-014-2264-y text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Grignon O. Emergency Department, Hôtel-Dieu, Centre Hospitalier Universitaire de Nantes, 1 Place Alexis-Ricordeau, 44000, Nantes, France aut NATIONALLICENCE 700 1- Montassier E. Emergency Department, Hôtel-Dieu, Centre Hospitalier Universitaire de Nantes, 1 Place Alexis-Ricordeau, 44000, Nantes, France aut NATIONALLICENCE 700 1- Corvec S. EA3826 Thérapeutiques Cliniques et Expérimentales des Infections, Faculté de Médecine & Pharmacie, Université de Nantes, 1 Rue Gaston-Veil, 44000, Nantes, France aut NATIONALLICENCE 700 1- Lepelletier D. EA3826 Thérapeutiques Cliniques et Expérimentales des Infections, Faculté de Médecine & Pharmacie, Université de Nantes, 1 Rue Gaston-Veil, 44000, Nantes, France aut NATIONALLICENCE 700 1- Hardouin J.-B EA4275 SPHERE Biostatistics Pharmacoepidemiology and Human Science Research Team, Faculté de Médecine & Pharmacie, Université de Nantes, 1 Rue Gaston-Veil, 44000, Nantes, France aut NATIONALLICENCE 700 1- Caillon J. EA3826 Thérapeutiques Cliniques et Expérimentales des Infections, Faculté de Médecine & Pharmacie, Université de Nantes, 1 Rue Gaston-Veil, 44000, Nantes, France aut NATIONALLICENCE 700 1- Batard E. Emergency Department, Hôtel-Dieu, Centre Hospitalier Universitaire de Nantes, 1 Place Alexis-Ricordeau, 44000, Nantes, France aut NATIONALLICENCE 773 0- European Journal of Clinical Microbiology & Infectious Diseases Springer Berlin Heidelberg 34/3(2015-03-01), 571-577 0934-9723 34:3<571 2015 34 10096