Multidrug resistance in urinary E. coli higher in males compared to females.

IF 1.7 3区 医学 Q3 UROLOGY & NEPHROLOGY
Narayan Khanal, Colin H Cortie, Chloe Story, Sandra Jones, Kylie J Mansfield, Spiros Miyakis, Caitlin Keighley
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Abstract

Background: Urinary tract infections (UTIs) are common however the widespread use of antibiotics has led to a rise in antimicrobial resistance (AMR) amongst uropathogens, rendering a significant proportion of infections resistant to first line treatment. AMR in UTIs may differentially affect men and women, younger and older patients. The purpose of this study was to investigate MDR (multi-drug resistance) and AMR in males and females in an Australian health district.

Methods: There were 85,844 E. coli urinary isolates (2007-2020) analysed from adult patients. An E. coli isolate with MDR was defined as resistant to at least 1 agent in ≥ 3 antimicrobial classes. Chi-square tests and relative risk were calculated by comparing resistance in males and females and by age for antibiotics commonly used to treat UTIs in hospital and community collected samples.

Results: There was a higher proportion of MDR E. coli in males compared to females in both the community (6.4% vs. 5.2%, P < 0.001) and hospital datasets (16.5% vs. 12.8%, P < 0.001). The proportions of MDR for both males and females were significantly higher in the hospital setting. Resistance rates were higher in males compared to females for amoxicillin, amoxicillin/clavulanate, cephalexin and norfloxacin (p < 0.005), though not for trimethoprim. Antibiotic resistance was seen to increase over time.

Conclusions: A higher proportion of MDR E. coli were noted in urine samples from males compared with females, possibly due to the increased likelihood of prior treatment for UTIs in men. Antimicrobial stewardship interventions could be targeted towards this cohort to address increasing rates of AMR.

与女性相比,男性尿液中大肠杆菌的多药耐药性更高。
背景:尿路感染(UTI)很常见,但抗生素的广泛使用已导致尿路病原体的抗菌药耐药性(AMR)上升,使很大一部分感染对一线治疗产生耐药性。尿路感染中的 AMR 对男性和女性、年轻患者和老年患者的影响可能有所不同。本研究的目的是调查澳大利亚一个卫生区男性和女性的 MDR(多重耐药性)和 AMR:方法:分析了来自成年患者的 85,844 份大肠杆菌尿液分离物(2007-2020 年)。具有 MDR 的大肠杆菌分离物被定义为对≥ 3 种抗菌剂中的至少 1 种抗菌剂具有耐药性。通过比较医院和社区收集样本中治疗UTI常用抗生素的耐药性,计算出男性和女性以及不同年龄的耐药性的卡方检验和相对风险:在社区和医院样本中,男性对 MDR 大肠杆菌的耐药性比例高于女性(6.4% 对 5.2%,P 结论:男性对 MDR 大肠杆菌的耐药性比例高于女性(6.4% 对 5.2%,P 结论):与女性相比,男性尿液样本中MDR大肠杆菌的比例更高,这可能是由于男性之前接受过UTI治疗的可能性更大。可以针对这一人群采取抗菌药物管理干预措施,以应对日益增长的 AMR 感染率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
BMC Urology
BMC Urology UROLOGY & NEPHROLOGY-
CiteScore
3.20
自引率
0.00%
发文量
177
审稿时长
>12 weeks
期刊介绍: BMC Urology is an open access journal publishing original peer-reviewed research articles in all aspects of the prevention, diagnosis and management of urological disorders, as well as related molecular genetics, pathophysiology, and epidemiology. The journal considers manuscripts in the following broad subject-specific sections of urology: Endourology and technology Epidemiology and health outcomes Pediatric urology Pre-clinical and basic research Reconstructive urology Sexual function and fertility Urological imaging Urological oncology Voiding dysfunction Case reports.
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