Trends in Antimicrobial Susceptibility of Escherichia coli Isolates in a Taiwanese Child Cohort with Urinary Tract Infections between 2004 and 2018
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Data Source
2.2. Outcome Measurements
2.3. Statistical Analysis
3. Results
3.1. Incidence of E. coli in Community-Associated UTIs
3.2. Trends in Antimicrobial-Drugs-Resistant E. coli Isolates in CA-UTIs
3.3. Outcomes and Factors Associated with E. coli Resistance to Third Generation Cephalosporin
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Heading | Overall * | 3GCs-Resistant (n = 822) | 3GCs-Susceptible (n = 6556) | p-Value # | ||
---|---|---|---|---|---|---|
N | n | (%) | n | (%) | ||
In-hospital death | 27 | 6 | (0.73) | 21 | (0.32) | 0.1133 |
Length of stay (day), | <0.0001 | |||||
Mean (SD) | 7378 | 8.09 | (4.59) | 6.78 | (3.53) | |
Median (IQR) | 7.00 | (5.00–10.00) | 6.00 | (5.00–8.00) | ||
Discharge diagnosis with bacteremia | 311 | 45 | (5.47) | 266 | (4.06) | 0.0566 |
E. coli | 106 | 13 | (1.58) | 93 | (1.42) | 0.7113 |
Heading | Overall * | 3GCs-Resistant (n = 822) | 3GCs-Susceptible (n = 6556) | p-Value # | ||
---|---|---|---|---|---|---|
n | n | (%) | n | (%) | ||
Age at admission | 0.4516 | |||||
≤28 days | 379 | 39 | (4.74) | 340 | (5.19) | |
29 days to < 1 year | 5534 | 634 | (77.13) | 4900 | (74.74) | |
1 to 2 years | 808 | 86 | (10.46) | 722 | (11.01) | |
3 to 17 years | 657 | 63 | (7.66) | 594 | (9.06) | |
Sex | 0.0415 | |||||
Boys | 4189 | 494 | (60.10) | 3695 | (56.36) | |
Girls | 3189 | 328 | (39.90) | 2861 | (43.64) | |
Recent medical visits ≤ 3 months prior, visit | ||||||
Outpatient | 0.4501 | |||||
None | 6410 | 721 | (87.71) | 5689 | (86.78) | |
1–3 | 722 | 71 | (8.64) | 651 | (9.93) | |
≥4 | 246 | 30 | (3.65) | 216 | (3.29) | |
Emergency department | 0.2825 | |||||
None | 6911 | 764 | (92.94) | 6147 | (93.76) | |
1 | 365 | 49 | (5.96) | 316 | (4.82) | |
≥2 | 102 | 9 | (1.09) | 93 | (1.42) | |
Hospitalization | 0.0834 | |||||
None | 7070 | 784 | (95.38) | 6286 | (95.88) | |
1 | 279 | 31 | (3.77) | 248 | (3.78) | |
≥2 | 29 | 7 | (0.85) | 22 | (0.34) | |
PMCA, CD | <0.0001 | |||||
Without CD | 6640 | 724 | (88.08) | 5916 | (90.24) | |
Non-complex CD | 442 | 40 | (4.87) | 402 | (6.13) | |
Complex CD | 296 | 58 | (7.06) | 238 | (3.63) | |
Recent antibiotic treatment ≤ 3 months prior | ||||||
Sum of regimen | <0.0001 | |||||
None | 6427 | 674 | (82.00) | 5753 | (87.75) | |
1 | 515 | 79 | (9.61) | 436 | (6.65) | |
≥2 | 436 | 69 | (8.39) | 367 | (5.60) | |
Amoxicillin/clavulanic acid | 286 | 49 | (5.96) | 237 | (3.62) | 0.0010 |
Amikacin | 11 | 6 | (0.73) | 5 | (0.08) | <0.0001 |
Ciprofloxacin | 9 | 5 | (0.61) | 4 | (0.06) | <0.0001 |
Ceftriaxone | 38 | 9 | (1.09) | 29 | (0.44) | 0.0137 |
Cefazolin | 37 | 10 | (1.22) | 27 | (0.41) | 0.0021 |
Ertapenem | 412 | 63 | (7.66) | 349 | (5.32) | 0.0059 |
Gentamicin | 550 | 75 | (9.12) | 475 | (7.25) | 0.0532 |
Levofloxacin | 1 | 0 | (0.00) | 1 | (0.02) | -- |
Sulfamethoxazole–Trimethoprim | 133 | 36 | (4.38) | 97 | (1.48) | <0.0001 |
Piperacillin/Tazobactam | 2 | 1 | (0.12) | 1 | (0.02) | -- |
Heading | aOR | 95%CI | p-Value | |
---|---|---|---|---|
Age at index hospitalization | ||||
≤28 days | 1 | |||
29 days to < 1 year | 1.08 | (0.77 | 1.52) | 0.6589 |
1 to 2 years | 0.98 | (0.65 | 1.47) | 0.9059 |
3 to 17 years | 0.80 | (0.51 | 1.24) | 0.3075 |
Boy (vs. girl) | 1.13 | (0.96 | 1.32) | 0.1337 |
Healthcare service use ≤3 months prior, visit | ||||
Outpatient setting | ||||
None | 1 | |||
1–3 | 0.80 | (0.60 | 1.08) | 0.1449 |
≥4 | 0.70 | (0.43 | 1.13) | 0.1434 |
Emergency department | ||||
None | 1 | |||
1 | 1.34 | (0.95 | 1.88) | 0.0910 |
≥2 | 0.77 | (0.37 | 1.59) | 0.4785 |
Hospitalization | ||||
None | 1 | |||
1 | 0.98 | (0.63 | 1.53) | 0.9414 |
≥2 | 2.15 | (0.83 | 5.58) | 0.1176 |
PMCA, CD | ||||
Non-Chronic | 1 | |||
Non-complex Chronic | 0.83 | (0.59 | 1.18) | 0.3005 |
Complex Chronic | 2.04 | (1.47 | 2.83) | <0.0001 |
Sum of antibiotic regimen use ≤ 3 months prior | ||||
None | 1 | |||
1 | 1.49 | (1.15 | 1.94) | 0.0031 |
≥2 | 1.53 | (1.16 | 2.02) | 0.0024 |
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Chen, H.-E.; Tain, Y.-L.; Kuo, H.-C.; Hsu, C.-N. Trends in Antimicrobial Susceptibility of Escherichia coli Isolates in a Taiwanese Child Cohort with Urinary Tract Infections between 2004 and 2018. Antibiotics 2020, 9, 501. https://doi.org/10.3390/antibiotics9080501
Chen H-E, Tain Y-L, Kuo H-C, Hsu C-N. Trends in Antimicrobial Susceptibility of Escherichia coli Isolates in a Taiwanese Child Cohort with Urinary Tract Infections between 2004 and 2018. Antibiotics. 2020; 9(8):501. https://doi.org/10.3390/antibiotics9080501
Chicago/Turabian StyleChen, Hung-En, You-Lin Tain, Hsiao-Ching Kuo, and Chien-Ning Hsu. 2020. "Trends in Antimicrobial Susceptibility of Escherichia coli Isolates in a Taiwanese Child Cohort with Urinary Tract Infections between 2004 and 2018" Antibiotics 9, no. 8: 501. https://doi.org/10.3390/antibiotics9080501