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Fluoroquinolone antibiotic users select fluoroquinolone-resistant ESBL-producing Enterobacteriaceae (ESBL-PE) - Data of a prospective traveller study.
- Source :
-
Travel medicine and infectious disease [Travel Med Infect Dis] 2017 Mar - Apr; Vol. 16, pp. 23-30. Date of Electronic Publication: 2017 Jan 31. - Publication Year :
- 2017
-
Abstract
- Background: One third of travellers to the poor regions of the (sub)tropics become colonized by extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE). Co-resistance to non-beta-lactam antibiotics complicates the treatment of potential ESBL-PE infections.<br />Methods: We analysed co-resistance to non-beta-lactams among travel-acquired ESBL-PE isolates of 90 visitors to the (sub)tropics with respect to major risk factors of colonization: destination, age, travellers' diarrhoea (TD) and antibiotic (AB) use.<br />Results: Of the ESBL-PE isolates, 53%, 52%, 73%, and 2% proved co-resistant to ciprofloxacin, tobramycin, co-trimoxazole, and nitrofurantoin, respectively. The rates were similar among those with (TD+) or without (TD-) travellers' diarrhoea. Among fluoroquinolone-users vs. AB non-users, the co-resistance rates for ciprofloxacin were 95% versus 37% (p = 0.001), for tobramycin 85% versus 43% (p = 0.005), co-trimoxazole 85% versus 68% (p = 0.146), and nitrofurantoin 5% versus 2% (p = 0.147). In multivariable analysis co-resistance to ciprofloxacin was associated with increasing age, fluoroquinolone use, and tobramycin resistance.<br />Conlusions: While TD predisposes to ESBL-PE non-selectively, antimicrobial use favours strains resistant to drug taken and, simultaneously, any drug with resistance genetically linked to the drug used. Antibiotics taken during travel predispose to ESBL-PE with a high co-resistance rate.<br /> (Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
- Subjects :
- Adolescent
Adult
Aged
Child
Child, Preschool
Cohort Studies
Enterobacteriaceae isolation & purification
Feces microbiology
Female
Humans
Infant
Infant, Newborn
Male
Microbial Sensitivity Tests
Middle Aged
Risk Factors
Young Adult
beta-Lactamases
Anti-Bacterial Agents pharmacology
Carrier State epidemiology
Carrier State microbiology
Drug Resistance, Bacterial
Enterobacteriaceae drug effects
Enterobacteriaceae Infections epidemiology
Enterobacteriaceae Infections microbiology
Fluoroquinolones pharmacology
Travel statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 1873-0442
- Volume :
- 16
- Database :
- MEDLINE
- Journal :
- Travel medicine and infectious disease
- Publication Type :
- Academic Journal
- Accession number :
- 28153711
- Full Text :
- https://doi.org/10.1016/j.tmaid.2017.01.003