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Antimicrobial Resistance & Infection Control
Published in: Antimicrobial Resistance & Infection Control 1/2020

01-12-2020 | Escherichia Coli | Research

Risk factors for quinolone-resistant Escherichia coli infection: a systematic review and meta-analysis

Authors: Dong-Mei Zhu, Qiu-Hong Li, Yan Shen, Qin Zhang

Published in: Antimicrobial Resistance & Infection Control | Issue 1/2020

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Abstract

Background

Antimicrobial resistance to quinolone is rising worldwide, especially in Escherichia coli causing various infections. Although many studies have been conducted to identify the risk factors for quinolone-resistant Escherichia coli (QREC) infection, the results are inconsistent and have not been systematically reported. The aim of the present study is to conduct a systematic review and meta-analysis to evaluate the potential risk factors for QREC infection.

Methods

A systematic search was performed to collect published data in the EMBASE, PubMed, and the Cochrane Library up to April 2019. Risk factors were analyzed using the pooled odds ratio (ORs) with 95% confidence interval (CIs).

Results

Twenty-seven trials involving 67,019 participants were included in the present study. The following risk factors associated with QREC infection were identified: (1) male (OR = 1.41), (2) hepatic cirrhosis (OR = 2.05), (3) diabetes mellitus (OR = 1.62), (4) cardiovascular disease (OR = 1.76), (5) neurogenic bladder (OR = 8.66), (6) renal dysfunction (OR = 2.47), (7) transplantation (OR = 2.37), (8) urinary tract infection (OR = 2.79) and urinary tract abnormality (OR = 1.85), (9) dementia (OR = 5.83), (10) heart failure (OR = 5.63), (11) neurologic disease (OR = 2.80), (12) immunosuppressive drugs (OR = 2.02), (13) urinary catheter (OR = 4.39), (14) nursing home resident (OR = 4.63), (15) prior surgery (OR = 2.54), (16) quinolones (OR = 7.67), (17) other antibiotics (OR = 2.74), (18) hospitalization (OR = 2.06) and (19) nosocomial infection acquisition (OR = 2.35).

Conclusions

QREC infection was associated with nineteen risk factors including prior quinolones use, hospitalization, and several comorbidities. Reducing exposure to these risk factors and modification of antibiotic use are important to prevent quinolone resistance.
Appendix
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Literature
1.
Sharma PC, Jain A, Jain S, Pahwa R, Yar MS. Ciprofloxacin. Review on developments in synthetic, analytical, and medicinal aspects. J Enzyme Inhib Med Chem. 2010;25(4):577–89.PubMedCrossRef
2.
Garau J, Xercavins M, Rodriguez-Carballeira M, Gomez-Vera JR, Coll I, Vidal D, Llovet T, Ruiz-Bremon A. Emergence and dissemination of quinolone-resistant Escherichia coli in the community. Antimicrob Agents Chemother. 1999;43(11):2736–41.PubMedPubMedCentralCrossRef
3.
Huotari K, Tarkka E, Valtonen V, Kolho E. Incidence and risk factors for nosocomial infections caused by fluoroquinolone-resistant Escherichia coli. Eur J Clin Microbiol Infect Dis. 2003;22(8):492–5.PubMedCrossRef
4.
Guillemot D. Antibiotic use in humans and bacterial resistance. Curr Opin Microbiol. 1999;2(5):494–8.PubMedCrossRef
5.
Wenzel RP. The antibiotic pipeline--challenges, costs, and values. N Engl J Med. 2004;351(6):523–6.PubMedCrossRef
6.
7.
Touchon M, Hoede C, Tenaillon O, Barbe V, Baeriswyl S, Bidet P, Bingen E, Bonacorsi S, Bouchier C, Bouvet O, et al. Organised genome dynamics in the Escherichia coli species results in highly diverse adaptive paths. PLoS Genet. 2009;5(1):e1000344.PubMedPubMedCentralCrossRef
8.
Hatahet F, Blazyk JL, Martineau E, Mandela E, Zhao Y, Campbell RE, Beckwith J, Boyd D. Altered Escherichia coli membrane protein assembly machinery allows proper membrane assembly of eukaryotic protein vitamin K epoxide reductase. Proc Natl Acad Sci U S A. 2015;112(49):15184–9.PubMedPubMedCentralCrossRef
9.
Huttner A, Hatz C, van den Dobbelsteen G, Abbanat D, Hornacek A, Frölich R, Dreyer AM, Martin P, Davies T, Fae K, et al. Safety, immunogenicity, and preliminary clinical efficacy of a vaccine against extraintestinal pathogenic Escherichia coli in women with a history of recurrent urinary tract infection: a randomised, single-blind, placebo-controlled phase 1b trial. Lancet Infect Dis. 2017;17(5):528–37.PubMedCrossRef
10.
Manges AR, Johnson JR. Food-borne origins of Escherichia coli causing extraintestinal infections. Clin Infect Dis. 2012;55(5):712–9.PubMedCrossRef
11.
Recacha E, Machuca J, Díaz-Díaz S, García-Duque A, Ramos-Guelfo M, Docobo-Pérez F, Blázquez J, Pascual A, Rodríguez-Martínez JM. Suppression of the SOS response modifies spatiotemporal evolution, post-antibiotic effect, bacterial fitness and biofilm formation in quinolone-resistant Escherichia coli. J Antimicrob Chemother. 2019;74(1):66–73.PubMed
12.
Xu X, Cui S, Zhang F, Luo Y, Gu Y, Yang B, Li F, Chen Q, Zhou G, Wang Y, et al. Prevalence and characterization of cefotaxime and ciprofloxacin co-resistant escherichia coli isolates in retail chicken carcasses and ground pork, China. Microb Drug Resist. 2014;20(1):73–81.PubMedCrossRef
13.
Kratochwill L, Powers M, McGraw MA, King L, O'Neill JM, Venkat A. Factors associated with ciprofloxacin-resistant Escherichia coli urinary tract infections in discharged ED patients. Am J Emerg Med. 2015;33(10):1473–6.PubMedCrossRef
14.
Pena C, Albareda JM, Pallares R, Pujol M, Tubau F, Ariza J. Relationship between quinolone use and emergence of ciprofloxacin- resistant Escherichia coli in bloodstream infections. Antimicrob Agents Chemother. 1995;39(2):520–4.PubMedPubMedCentralCrossRef
15.
Stang A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol. 2010;25(9):603–5.PubMedCrossRef
16.
Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ (Clinical research ed). 2003;327(7414):557–60.CrossRef
17.
Higgins JP, Thompson SG. Quantifying heterogeneity in a meta-analysis. Stat Med. 2002;21(11):1539–58.PubMedCrossRef
18.
Cheong HJ, Yoo CW, Sohn JW, Kim WJ, Kim MJ, Park SC. Bacteremia due to quinolone-resistant Escherichia coli in a teaching hospital in South Korea. Clin Infect Dis. 2001;33(1):48–53.PubMedCrossRef
19.
Sotto A, De Boever CM, Fabbro-Peray P, Gouby A, Sirot D, Jourdan J. Risk factors for antibiotic-resistant Escherichia coli isolated from hospitalized patients with urinary tract infections: a prospective study. J Clin Microbiol. 2001;39(2):438–44.PubMedPubMedCentralCrossRef
20.
Eom JS, Hwang BY, Sohn JW, Kim WJ, Kim MJ, Park SC, Cheong HJ. Clinical and molecular epidemiology of quinolone-resistant Escherichia coli isolated from urinary tract infection. Microb Drug Resist. 2002;8(3):227–34.PubMedCrossRef
21.
Lautenbach E, Fishman NO, Bilker WB, Castiglioni A, Metlay JP, Edelstein PH, Strom BL. Risk factors for fluoroquinolone resistance in nosocomial Escherichia coli and Klebsiella pneumoniae infections. Arch Intern Med. 2002;162(21):2469–77.PubMedCrossRef
22.
Killgore KM, March KL, Guglielmo BJ. Risk factors for community-acquired ciprofloxacin-resistant Escherichia coli urinary tract infection. Ann Pharmacother. 2004;38(7–8):1148–52.PubMedCrossRef
23.
24.
Colodner R, Kometiani I, Chazan B, Raz R. Risk factors for community-acquired urinary tract infection due to quinolone-resistant E. coli. Infection. 2008;36(1):41–5.PubMedCrossRef
25.
Johnson L, Sabel A, Burman WJ, Everhart RM, Rome M, MacKenzie TD, Rozwadowski J, Mehler PS, Price CS. Emergence of Fluoroquinolone resistance in outpatient urinary Escherichia coli isolates. Am J Med. 2008;121(10):876–84.PubMedCrossRef
26.
Lin CY, Huang SH, Chen TC, Lu PL, Lin WR, Chen YH. Risk factors of ciprofloxacin resistance in urinary Escherichia coli isolates. J Microbiol Immunol Infect. 2008;41(4):325–31.PubMed
27.
Lautenbach E, Metlay JP, Weiner MG, Bilker WB, Tolomeo P, Mao X, Nachamkin I, Fishman NO. Gastrointestinal tract colonization with fluoroquinolone-resistant Escherichia coli in hospitalized patients: changes over time in risk factors for resistance. Infect Control Hosp Epidemiol. 2009;30(1):18–24.PubMedPubMedCentralCrossRef
28.
Rooney PJ, O'Leary MC, Loughrey AC, McCalmont M, Smyth B, Donaghy P, Badri M, Woodford N, Karisik E, Livermore DM. Nursing homes as a reservoir of extended-spectrum beta-lactamase (ESBL)-producing ciprofloxacin-resistant Escherichia coli. J Antimicrob Chemother. 2009;64(3):635–41.PubMedCrossRef
29.
Yagci D, Yoruk F, Azap A, Memikoglu O. Prevalence and risk factors for selection of quinolone-resistant escherichia coli strains in fecal flora of patients receiving quinolone therapy. Antimicrob Agents Chemother. 2009;53(3):1287–9.PubMedCrossRef
30.
Jang WH, Yoo DH, Park SW. Prevalence of and risk factors for levofloxacin-Resistant E. coli isolated from outpatients with urinary tract infection. Korean J Urol. 2011;52(8):554–9.PubMedPubMedCentralCrossRef
31.
van der Starre WE, van Nieuwkoop C, Paltansing S, van't Wout JW, Groeneveld GH, Becker MJ, Koster T, Wattel-Louis GH, Delfos NM, Ablij HC, et al. Risk factors for fluoroquinolone-resistant Escherichia coli in adults with community-onset febrile urinary tract infection. J Antimicrob Chemother. 2011;66(3):650–6.PubMedCrossRef
32.
Smithson A, Chico C, Ramos J, Netto C, Sanchez M, Ruiz J, Porron R, Bastida MT. Prevalence and risk factors for quinolone resistance among Escherichia coli strains isolated from males with community febrile urinary tract infection. Eur J Clin Microbiol Infect Dis. 2012;31(4):423–30.PubMedCrossRef
33.
Bailey AM, Weant KA, Baker SN. Prevalence and risk factor analysis of resistant Escherichia coli urinary tract infections in the emergency department. Pharm Pract. 2013;11(2):96–101.CrossRef
34.
Han JH, Bilker WB, Nachamkin I, Tolomeo P, Mao X, Fishman NO, Lautenbach E. Impact of antibiotic use during hospitalization on the development of gastrointestinal colonization with Escherichia coli with reduced fluoroquinolone susceptibility. Infect Control Hosp Epidemiol. 2013;34(10):1070–6.PubMedPubMedCentralCrossRef
35.
Bedoin M, Cazorla C, Lucht F, Berthelot P, Boyer M, Carricajo A, Guérin T, Viallon A. Risk factors for quinolone-resistance in women presenting with Escherichia coli acute pyelonephritis. Med Mal Infect. 2014;44(5):206–16.PubMedCrossRef
36.
Kim J, Kang CI, Joo EJ, Ha YE, Cho SY, Gwak GY, Chung DR, Peck KR, Song JH. Risk factor of community-onset spontaneous bacterial peritonitis caused by fluoroquinolone-resistant Escherichia coli in patients with cirrhosis. Liver Int. 2014;34(5):695–9.PubMedCrossRef
37.
Park KH, Oh WS, Kim ES, Park SW, Hur JA, Kim YK, Moon C, Lee JH, Lee CS, Kim BN. Factors associated with ciprofloxacin- and cefotaxime-resistant Escherichia coli in women with acute pyelonephritis in the emergency department. Int J Infect Dis. 2014;23:8–13.PubMedCrossRef
38.
Jadoon RJ, Jalal-ud-din M, Khan SA. E. coli resistance to ciprofloxacin and common associated factors. J Coll Physicians Surg Pak. 2015;25(11):824–7.PubMed
39.
Saade EA, Suwantarat N, Zabarsky TF, Wilson B, Donskey CJ. Fluoroquinolone-resistant Escherichia coli infections after Transrectal biopsy of the prostate in the veterans affairs healthcare system. Pathog Immun. 2016;1(2):243–57.PubMedPubMedCentralCrossRef
40.
Mulder M, Kiefte-de Jong JC, Goessens WHF, Visser H, Hofman A, Stricker BH, Verbon A. Risk factors for resistance to ciprofloxacin in community-acquired urinary tract infections due to Escherichia coli in an elderly population. J Antimicrob Chemother. 2017;72(1):281–9.PubMedCrossRef
41.
Yoshida H, Kojima T, Yamagishi J, Nakamura S. Quinolone-resistant mutations of the gyrA gene of Escherichia coli. Mol Gen Genet. 1988;211(1):1–7.PubMedCrossRef
Metadata
Title
Risk factors for quinolone-resistant Escherichia coli infection: a systematic review and meta-analysis
Authors
Dong-Mei Zhu
Qiu-Hong Li
Yan Shen
Qin Zhang
Publication date
01-12-2020
Publisher
BioMed Central
Published in
Antimicrobial Resistance & Infection Control / Issue 1/2020
Electronic ISSN: 2047-2994
DOI
https://doi.org/10.1186/s13756-019-0675-3

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