Top

Published in:

01-12-2013 | Original Article

Increasing prevalence of ciprofloxacin resistance in extended-spectrum-β-lactamase-producing Escherichia coli urinary isolates

Authors: G. Bonkat, G. Müller, O. Braissant, R. Frei, S. Tschudin-Suter, M. Rieken, S. Wyler, T. C. Gasser, A. Bachmann, A. F. Widmer

Published in: World Journal of Urology | Issue 6/2013

Abstract

Purpose

To describe the incidence and drug susceptibility profiles of uropathogenic extended-spectrum-β-lactamase-producing Escherichia coli (ESBL-EC) during a 10-year period and to identify differences in resistance patterns between urological and non-urological ESBL-EC isolates.

Methods

Retrospective analysis of 191,564 urine samples obtained during 2001 to 2010 at the University Hospital Basel, Switzerland. The computerized database of the Clinical Microbiology Laboratory and the Division of Infectious Diseases and Hospital Epidemiology was used to identify ESBL-EC positive urine samples. ESBL-EC isolates were stratified according their origin into two groups: Urology and non-Urology isolates.

Results

The rate of ESBL-EC positive urine samples increased significantly during the study period (3 in 2001 compared to 55 in 2010, p < 0.05). The most active agents were imipenem, meropenem, and fosfomycin (100 %), followed by amikacin (99.1 %) and nitrofurantoin (84 %). The least active substances were ampicillin-clavulanate (20 %), sulfamethoxazole (28 %), and ciprofloxacin (29.6 %). ESBL-EC isolates from urological and non-urological patients showed similar susceptibility profiles. However, ESBL-EC isolates from urological patients were significantly less susceptible to ciprofloxacin compared to non-urological isolates (14.7 vs. 32.7 %, p < 0.05).

Conclusions

The rate of urinary ESBL-EC isolates is increasing. Their susceptibility to nitrofurantoin, fosfomycin, and carbapenems is excellent, whereas ampicillin-clavulanate, sulfamethoxazole, and ciprofloxacin demonstrate only low susceptibility. In particular, the use of ciprofloxacin should be strictly avoided in urologic patients with suspicion for an ESBL-EC urinary tract infection as well as routine antibiotic prophylaxis prior to urological interventions if not explicit indicated by current international guidelines or local resistance patterns.

Ronald A (2002) The etiology of urinary tract infection: traditional and emerging pathogens. Am J Med 113(Suppl 1A):14S–19SPubMedCrossRef

Gupta K, Hooton TM, Stamm WE (2001) Increasing antimicrobial resistance and the management of uncomplicated community-acquired urinary tract infections. Ann Intern Med 135:41–50PubMedCrossRef

Naber KG, Schito G, Botto H, Palou J, Mazzei T (2008) Surveillance study in Europe and Brazil on clinical aspects and Antimicrobial Resistance Epidemiology in Females with Cystitis (ARESC): implications for empiric therapy. Eur Urol 54:1164–1175PubMedCrossRef

Geser N, Stephan R, Kuhnert P, Zbinden R, Kaeppeli U, Cernela N, Haechler H (2011) Fecal carriage of extended-spectrum beta-lactamase-producing Enterobacteriaceae in swine and cattle at slaughter in Switzerland. J Food Prot 74:446–449PubMedCrossRef

Li B, Sun JY, Liu QZ, Han LZ, Huang XH, Ni YX (2011) High prevalence of CTX-M beta-lactamases in faecal Escherichia coli strains from healthy humans in Fuzhou, China. Scand J Infect Dis 43:170–174PubMedCrossRef

Pitout JD, Laupland KB (2008) Extended-spectrum beta-lactamase-producing Enterobacteriaceae: an emerging public-health concern. Lancet Infect Dis 8:159–166PubMedCrossRef

Ben-Ami R, Rodriguez-Bano J, Arslan H, Pitout JD, Quentin C, Calbo ES, Azap OK, Arpin C, Pascual A, Livermore DM, Garau J, Carmeli Y (2009) A multinational survey of risk factors for infection with extended-spectrum beta-lactamase-producing enterobacteriaceae in nonhospitalized patients. Clin Infect Dis 49:682–690PubMedCrossRef

Talbot GH, Bradley J, Edwards JE Jr, Gilbert D, Scheld M, Bartlett JG (2006) Bad bugs need drugs: an update on the development pipeline from the Antimicrobial Availability Task Force of the Infectious Diseases Society of America. Clin Infect Dis 42:657–668PubMedCrossRef

Grabe M, Bjerklund-Johansen TE, Botto H, Wullt B, Cek M, Naber KG, Pickard RS, Tenke P, Wagenlehner F (2012) Guidelines on urological infections. Eur Assoc Urol. http://www.uroweb.org

10.

Wolf JS, Bennet CJ, Dmochowski RR, Hollenbeck BK, Pearle MS, Schaeffer AJ (2012) Best practice policy statement on urologic surgery antimicrobial prophylaxis. Am Urol Assoc. http://www.auanet.org/content/clinical-practice-guidelines/clinical-guidelines.cfm#2

11.

Kuster SP, Hasse B, Huebner V, Bansal V, Zbinden R, Ruef C, Ledergerber B, Weber R (2010) Risks factors for infections with extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae at a tertiary care university hospital in Switzerland. Infection 38:33–40PubMedCrossRef

12.

Tschudin-Sutter S, Frei R, Dangel M, Stranden A, Widmer AF (2012) Rate of transmission of extended-spectrum beta-lactamase-producing enterobacteriaceae without contact isolation. Clin Infect Dis 55:1505–1511

13.

Rodriguez-Bano J, Navarro MD, Romero L, Martinez–Martinez L, Muniain MA, Perea EJ, Perez-Cano R, Pascual A (2004) Epidemiology and clinical features of infections caused by extended-spectrum beta-lactamase-producing Escherichia coli in nonhospitalized patients. J Clin Microbiol 42:1089–1094PubMedCrossRef

14.

Overdevest I, Willemsen I, Rijnsburger M, Eustace A, Xu L, Hawkey P, Heck M, Savelkoul P, Vandenbroucke-Grauls C, van der Zwaluw K, Huijsdens X, Kluytmans J (2011) Extended-spectrum beta-lactamase genes of Escherichia coli in chicken meat and humans, The Netherlands. Emerg Infect Dis 17:1216–1222PubMedCrossRef

15.

Ena J, Arjona F, Martinez-Peinado C, Lopez-Perezagua MM, Amador C (2006) Epidemiology of urinary tract infections caused by extended-spectrum beta-lactamase-producing Escherichia coli. Urology 68:1169–1174PubMedCrossRef

16.

Gupta K, Hooton TM, Naber KG, Wullt B, Colgan R, Miller LG, Moran GJ, Nicolle LE, Raz R, Schaeffer AJ, Soper DE (2011) International clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women: a 2010 update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases. Clin Infect Dis 52:e103–e120PubMedCrossRef

17.

Wagenlehner FM, van OE, Tenke P, Tandogdu Z, Cek M, Grabe M, Wullt B, Pickard R, Naber KG, Pilatz A, Weidner W, Bjerklund-Johansen TE (2012) Infective complications after prostate biopsy: outcome of the Global Prevalence Study of Infections in Urology (GPIU) 2010 and 2011, a prospective multinational multicentre prostate biopsy study. Eur Urol [Epub ahead of print]

18.

Blaettler L, Mertz D, Frei R, Elzi L, Widmer AF, Battegay M, Fluckiger U (2009) Secular trend and risk factors for antimicrobial resistance in Escherichia coli isolates in Switzerland 1997–2007. Infection 37:534–539PubMedCrossRef

19.

Schito GC (2003) Why fosfomycin trometamol as first line therapy for uncomplicated UTI? Int J Antimicrob Agents 22(Suppl 2):79–83PubMedCrossRef

20.

Estebanez A, Pascual R, Gil V, Ortiz F, Santibanez M, Perez BC (2009) Fosfomycin in a single dose versus a 7-day course of amoxicillin-clavulanate for the treatment of asymptomatic bacteriuria during pregnancy. Eur J Clin Microbiol Infect Dis 28:1457–1464PubMedCrossRef

21.

Garau J (2008) Other antimicrobials of interest in the era of extended-spectrum beta-lactamases: fosfomycin, nitrofurantoin and tigecycline. Clin Microbiol Infect 14(Suppl 1):198–202PubMedCrossRef

22.

de Cueto M, Hernandez JR, Lopez-Cerero L, Morillo C, Pascual A (2006) Activity of fosfomycin against extended-spectrum beta-lactamase producing Escherichia coli and Klebsiella pneumoniae. Enferm Infecc Microbiol Clin 24:613–616PubMedCrossRef

23.

Falagas ME, Kastoris AC, Kapaskelis AM, Karageorgopoulos DE (2010) Fosfomycin for the treatment of multidrug-resistant, including extended-spectrum beta-lactamase producing, Enterobacteriaceae infections: a systematic review. Lancet Infect Dis 10:43–50PubMedCrossRef

24.

Oteo J, Orden B, Bautista V, Cuevas O, Arroyo M, Martinez-Ruiz R, Perez-Vazquez M, Alcaraz M, Garcia-Cobos S, Campos J (2009) CTX-M-15-producing urinary Escherichia coli O25b-ST131-phylogroup B2 has acquired resistance to fosfomycin. J Antimicrob Chemother 64:712–717PubMedCrossRef

25.

Oteo J, Bautista V, Lara N, Cuevas O, Arroyo M, Fernandez S, Lazaro E, de Abajo FJ, Campos J (2010) Parallel increase in community use of fosfomycin and resistance to fosfomycin in extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli. J Antimicrob Chemother 65:2459–2463PubMedCrossRef

26.

Alhambra A, Cuadros JA, Cacho J, Gomez-Garces JL, Alos JI (2004) In vitro susceptibility of recent antibiotic-resistant urinary pathogens to ertapenem and 12 other antibiotics. J Antimicrob Chemother 53:1090–1094PubMedCrossRef

27.

Mody RM, Erwin DP, Summers AM, Carrero HA, Selby EB, Ewell AJ, Moran KA (2007) Ertapenem susceptibility of extended spectrum beta-lactamase-producing organisms. Ann Clin Microbiol Antimicrob 6:6PubMedCrossRef

28.

Tamayo J, Orden B, Cacho J, Cuadros J, Gomez-Garces JL, Alos JI (2007) Activity of ertapenem and other antimicrobials against ESBL-producing enterobacteria isolated from urine in patients from Madrid. Rev Esp Quimioter 20:334–338PubMed

29.

Kumarasamy KK, Toleman MA, Walsh TR, Bagaria J, Butt F, Balakrishnan R, Chaudhary U, Doumith M, Giske CG, Irfan S, Krishnan P, Kumar AV, Maharjan S, Mushtaq S, Noorie T, Paterson DL, Pearson A, Perry C, Pike R, Rao B, Ray U, Sarma JB, Sharma M, Sheridan E, Thirunarayan MA, Turton J, Upadhyay S, Warner M, Welfare W, Livermore DM, Woodford N (2010) Emergence of a new antibiotic resistance mechanism in India, Pakistan, and the UK: a molecular, biological, and epidemiological study. Lancet Infect Dis 10:597–602PubMedCrossRef

30.

Thomson KS, Moland ES (2001) Cefepime, piperacillin-tazobactam, and the inoculum effect in tests with extended-spectrum beta-lactamase-producing Enterobacteriaceae. Antimicrob Agents Chemother 45:3548–3554PubMedCrossRef

Title: Increasing prevalence of ciprofloxacin resistance in extended-spectrum-β-lactamase-producing Escherichia coli urinary isolates
Authors: G. Bonkat
G. Müller
O. Braissant
R. Frei
S. Tschudin-Suter
M. Rieken
S. Wyler
T. C. Gasser
A. Bachmann
A. F. Widmer
Publication date: 01-12-2013
Publisher: Springer Berlin Heidelberg
Published in: World Journal of Urology / Issue 6/2013
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-013-1031-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Increasing prevalence of ciprofloxacin resistance in extended-spectrum-β-lactamase-producing Escherichia coli urinary isolates

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 6/2013

Salvage therapy

Laparoscopic versus open bilateral intrafascial nerve-sparing radical prostatectomy after TUR-P for incidental prostate cancer: surgical outcomes and effect on postoperative urinary continence and sexual potency

Prevalence of the human papillomavirus (HPV) expression of the inner prepuce in asymptomatic boys and men

Salvage radical prostatectomy as management of locally recurrent prostate cancer: outcomes and complications

Minimally invasive percutaneous nephrolithotomy: an alternative to retrograde intrarenal surgery and shockwave lithotripsy

Improved performance of SPECT-CT In-111 capromab pendetide by correlation with diffusion-weighted magnetic resonance imaging for identifying metastatic pelvic lymphadenopathy in prostate cancer