Journal Article

Epidemiological Investigation of Fluoroquinolone Resistance in Infections Due to Extended-Spectrum β-Lactamase—Producing <i>Escherichia coli</i> and <i>Klebsiella pneumoniae</i>

Ebbing Lautenbach, Brian L. Strom, Warren B. Bilker, Jean Baldus Patel, Paul H. Edelstein and Neil O. Fishman

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 33, issue 8, pages 1288-1294
Published in print October 2001 | ISSN: 1058-4838
Published online October 2001 | e-ISSN: 1537-6591 | DOI: https://dx.doi.org/10.1086/322667
Epidemiological Investigation of Fluoroquinolone Resistance in Infections Due to Extended-Spectrum β-Lactamase—Producing Escherichia coli and Klebsiella pneumoniae

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The incidence of infections due to extended-spectrum β-lactamase (ESBL)-producing Escherichia coli and Klebsiella pneumoniae (ESBL-EK) has increased markedly in recent years. Treatment is difficult because of frequent multidrug resistance. Although fluoroquinolones offer effective therapy for ESBL-EK infections, their usefulness is threatened by increasing fluoroquinolone resistance. To identify risk factors for fluoroquinolone resistance in ESBL-EK infections, a case-control study of all patients with ESBL-EK infections from 1 June 1997 through 30 September 1998 was conducted. Of 77 ESBL-EK infections, 43 (55.8%) were resistant to fluoroquinolones. Independent risk factors for fluoroquinolone resistance were fluoroquinolone use (odds ratio [OR], 11.20; 95% confidence interval [CI], 1.99–63.19), aminoglycoside use (OR, 5.83; 95% CI, 1.12–30.43), and long-term care facility residence (OR, 3.39; 95% CI, 1.06–10.83). The genotypes of fluoroquinolone-resistant ESBL-EK isolates were closely related. Efforts should be directed at modification of these risk factors to preserve the utility of fluoroquinolones in the treatment of ESBL-EK infections.

Journal Article.  4015 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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