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Article: Antimicrobial resistance among uropathogens that cause acute uncomplicated cystitis in women in Hong Kong: a prospective multicenter study in 2006 to 2008

TitleAntimicrobial resistance among uropathogens that cause acute uncomplicated cystitis in women in Hong Kong: a prospective multicenter study in 2006 to 2008
Authors
Issue Date2010
PublisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/diagmicrobio
Citation
Diagnostic Microbiology And Infectious Disease, 2010, v. 66 n. 1, p. 87-93 How to Cite?
AbstractA prospective multicenter study was conducted to assess the epidemiology of antimicrobial resistance among uropathogens causing uncomplicated cystitis. Adult women with clinical diagnosis of uncomplicated cystitis were enrolled from 54 participating centers distributed all over Hong Kong during 2006 to 2008. A positive urine culture was found in 59.5% (352/592) patients. The patients had mean age of 44.9 years, and most (89.2%) were otherwise healthy. The most prevalent causative organism was Escherichia coli (77%), followed by other Enterobacteriaceae (14.2%), staphylococci (5.1%), and other Gram-positive bacteria (3.7%). The resistance rates of E. coli to co-trimoxazole and ciprofloxacin were 29.5% and 12.9%, respectively, and 14 isolates (5.2%) were confirmed as extended-spectrum β-lactamase (ESBL) producers. Of the ESBL producers, molecular studies showed CTX-M-14, CTX-M-24, or CTX-M-9. Nitrofurantoin and fosfomycin were active against >90% of the isolates, regardless of resistance phenotypes for other drugs. Pulsed-field gel electrophoresis of representative isolates showed that the antibiotic-resistant strains were genetically diverse. Patients with history of recent antibiotic use were significantly more likely to have infection by E. coli with co-trimoxazole resistance (odds ratio [OR], 2.8; 95% confidence interval [CI], 1.4-5.7; P = 0.003) and ciprofloxacin resistance (OR, 2.5; 95% CI, 1.1-5.8; P = 0.03). Knowledge of the resistance data and risk factors could inform better use of antibiotics for empiric therapy for acute uncomplicated cystitis. © 2010 Elsevier Inc. All rights reserved.
Persistent Identifierhttp://hdl.handle.net/10722/59404
ISSN
2015 Impact Factor: 2.45
2015 SCImago Journal Rankings: 1.142
ISI Accession Number ID
Funding AgencyGrant Number
Research Fund for the Control of Infectious Diseases
Food and Health Bureau, Government of the Hong Kong Special Administrative Region03040212
Funding Information:

The authors thank the Research Fund for the Control of Infectious Diseases and the Food and Health Bureau, Government of the Hong Kong Special Administrative Region, for supporting this study (project no. 03040212). They thank the doctors, nurses, and clerical and laboratory staff at the participating centers for assistance with patient recruitment and data collection. They are grateful to Eileen Lai for excellent technical support and Frances Wong and Goretti Tse for dedicated secretarial assistance.

References
Grants

 

DC FieldValueLanguage
dc.contributor.authorHo, Plen_HK
dc.contributor.authorYip, KSen_HK
dc.contributor.authorChow, KHen_HK
dc.contributor.authorLo, JYCen_HK
dc.contributor.authorQue, TLen_HK
dc.contributor.authorYuen, Kyen_HK
dc.date.accessioned2010-05-31T03:49:25Z-
dc.date.available2010-05-31T03:49:25Z-
dc.date.issued2010en_HK
dc.identifier.citationDiagnostic Microbiology And Infectious Disease, 2010, v. 66 n. 1, p. 87-93en_HK
dc.identifier.issn0732-8893en_HK
dc.identifier.urihttp://hdl.handle.net/10722/59404-
dc.description.abstractA prospective multicenter study was conducted to assess the epidemiology of antimicrobial resistance among uropathogens causing uncomplicated cystitis. Adult women with clinical diagnosis of uncomplicated cystitis were enrolled from 54 participating centers distributed all over Hong Kong during 2006 to 2008. A positive urine culture was found in 59.5% (352/592) patients. The patients had mean age of 44.9 years, and most (89.2%) were otherwise healthy. The most prevalent causative organism was Escherichia coli (77%), followed by other Enterobacteriaceae (14.2%), staphylococci (5.1%), and other Gram-positive bacteria (3.7%). The resistance rates of E. coli to co-trimoxazole and ciprofloxacin were 29.5% and 12.9%, respectively, and 14 isolates (5.2%) were confirmed as extended-spectrum β-lactamase (ESBL) producers. Of the ESBL producers, molecular studies showed CTX-M-14, CTX-M-24, or CTX-M-9. Nitrofurantoin and fosfomycin were active against >90% of the isolates, regardless of resistance phenotypes for other drugs. Pulsed-field gel electrophoresis of representative isolates showed that the antibiotic-resistant strains were genetically diverse. Patients with history of recent antibiotic use were significantly more likely to have infection by E. coli with co-trimoxazole resistance (odds ratio [OR], 2.8; 95% confidence interval [CI], 1.4-5.7; P = 0.003) and ciprofloxacin resistance (OR, 2.5; 95% CI, 1.1-5.8; P = 0.03). Knowledge of the resistance data and risk factors could inform better use of antibiotics for empiric therapy for acute uncomplicated cystitis. © 2010 Elsevier Inc. All rights reserved.en_HK
dc.languageengen_HK
dc.publisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/diagmicrobioen_HK
dc.relation.ispartofDiagnostic Microbiology and Infectious Diseaseen_HK
dc.rightsDiagnostic Microbiology and Infectious Disease. Copyright © Elsevier Inc.en_HK
dc.subject.meshAdulten_HK
dc.subject.meshAnti-Bacterial Agents - pharmacologyen_HK
dc.subject.meshChi-Square Distributionen_HK
dc.subject.meshCystitis - epidemiology - microbiologyen_HK
dc.subject.meshDrug Resistance, Bacterialen_HK
dc.subject.meshEnterobacteriaceae - drug effects - geneticsen_HK
dc.subject.meshEnterobacteriaceae Infections - epidemiology - metabolismen_HK
dc.subject.meshEscherichia coli - drug effects - geneticsen_HK
dc.subject.meshEscherichia coli Infections - epidemiology - microbiologyen_HK
dc.subject.meshFemaleen_HK
dc.subject.meshHong Kong - epidemiologyen_HK
dc.subject.meshHumansen_HK
dc.subject.meshMicrobial Sensitivity Testsen_HK
dc.subject.meshMiddle Ageden_HK
dc.subject.meshPhylogenyen_HK
dc.subject.meshProspective Studiesen_HK
dc.subject.meshRisk Factorsen_HK
dc.titleAntimicrobial resistance among uropathogens that cause acute uncomplicated cystitis in women in Hong Kong: a prospective multicenter study in 2006 to 2008en_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0732-8893&volume=&spage=&epage=&date=2009&atitle=Antimicrobial+resistance+among+uropathogens+that+cause+acute+uncomplicated+cystitis+in+women+in+Hong+Kong:+a+prospective+multicenter+study+in+2006+to+2008.en_HK
dc.identifier.emailHo, Pl:plho@hkucc.hku.hken_HK
dc.identifier.emailChow, KH:khchowb@hku.hken_HK
dc.identifier.emailYuen, Ky:kyyuen@hkucc.hku.hken_HK
dc.identifier.authorityHo, Pl=rp00406en_HK
dc.identifier.authorityChow, KH=rp00370en_HK
dc.identifier.authorityYuen, Ky=rp00366en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1016/j.diagmicrobio.2009.03.027en_HK
dc.identifier.pmid19446980-
dc.identifier.scopuseid_2-s2.0-71049128664en_HK
dc.identifier.hkuros165302en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-71049128664&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume66en_HK
dc.identifier.issue1en_HK
dc.identifier.spage87en_HK
dc.identifier.epage93en_HK
dc.identifier.isiWOS:000277576800012-
dc.publisher.placeUnited Statesen_HK
dc.relation.projectAntimicrobial resistance among uropathogens causing well-defined episodes of uncomplicated cystitis among adult women in primary care settings-
dc.identifier.scopusauthoridHo, Pl=7402211363en_HK
dc.identifier.scopusauthoridYip, KS=23020572500en_HK
dc.identifier.scopusauthoridChow, KH=7202180736en_HK
dc.identifier.scopusauthoridLo, JYC=7201650939en_HK
dc.identifier.scopusauthoridQue, TL=7003786628en_HK
dc.identifier.scopusauthoridYuen, Ky=36078079100en_HK
dc.identifier.citeulike5123726-

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