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Am J Infect Control ; 50(1): 86-91, 2022 01.
Article in English | MEDLINE | ID: mdl-34499977

ABSTRACT

OBJECTIVE: We aimed to identify differences in urinary E. coli resistance rates based on community type of patient residence (rural and urban). METHODS: This cross-sectional study examined antibiotic resistance of E. coli isolates from 12,604 urine specimens at a North Carolina hospital between 2016 and 2018. Using multivariable logistic regression modeling, we investigated the association between resistance and community type, adjusting for patient age, gender, season, and setting of infection onset. Analyses were performed using SAS Version 9.3 (SAS Institute, Cary, NC) at alpha = 0.05. RESULTS: Prevalence of resistance was highest for ampicillin (42.2%), ampicillin-sulbactam (24.7%), ciprofloxacin (21.8%), trimethoprim-sulfamethoxazole (SXT) (21.6%), and levofloxacin (21.4%). Rural compared to urban community type was significantly associated with resistance of E. coli urinary isolates to ciprofloxacin (adjusted odds ratio [aOR] = 1.29, 95% confidence interval [CI] = 1.16-1.43, P < .0001), levofloxacin (aOR = 1.28, 95% CI = 1.15-1.42, P < .0001), SXT (aOR = 1.15, 95% CI = 1.04-1.27, P = .01), and nitrofurantoin (aOR = 1.57, 95% CI = 1.13-2.17, P = .01). CONCLUSIONS: Rural community type may influence urinary E. coli resistance to fluoroquinolones, SXT, and nitrofurantoin, indicating the need for antimicrobial stewardship interventions in medically underserved populations.


Subject(s)
Escherichia coli Infections , Urinary Tract Infections , Anti-Bacterial Agents/pharmacology , Anti-Bacterial Agents/therapeutic use , Cross-Sectional Studies , Drug Resistance, Bacterial , Drug Resistance, Microbial , Escherichia coli , Escherichia coli Infections/drug therapy , Escherichia coli Infections/epidemiology , Hospitals, Community , Humans , Microbial Sensitivity Tests , North Carolina/epidemiology , Rural Population , Urinary Tract Infections/drug therapy , Urinary Tract Infections/epidemiology
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