Exposure to co-amoxiclav as a risk factor for co-amoxiclav-resistant Escherichia coli urinary tract infection.

Abstract

The objective of the study was to define whether individual exposure to co-amoxiclav is a risk factor for selecting co-amoxiclav-resistant Escherichia coli in vivo. One hundred and eight patients were included in our study as soon as they were found to have a urinary tract infection (UTI) due to E. coli. Stool probes were also undertaken for some of these patients. Co-amoxiclav administration in the month before diagnosing the UTI, and any treatment to cure the current UTI were recorded for all patients. When co-amoxiclav-resistant E. coli was detected in the stools after diagnosis of E. coli UTI, isolates were compared with urinary E. coli isolates in terms of clonal relatedness, beta-lactam susceptibility and mechanisms of beta-lactam resistance. The patients who had taken co-amoxiclav in the month before the reported E. coli UTI had a significantly higher risk of being infected with co-amoxiclav-resistant E. coli. Those patients treated with amoxicillin for a current infection were at greater risk of intestinal carriage of co-amoxiclav-resistant E. coli; those treated with co-amoxiclav had a greater risk of intestinal carriage of co-amoxiclav-resistant Gram-negative bacilli than patients treated with third-generation cephalosporins or fluoroquinolones. Hence, individual exposure to co-amoxiclav is a risk factor for UTIs caused by co-amoxiclav-resistant E. coli or for carrying co-amoxiclav-resistant Gram-negative bacilli in the digestive tract.

• Authors: Véronique Leflon-Guibout, Géraldine Ternat, Beate Heym, Marie-Hélène Nicolas-Chanoine
• Journal: The Journal of antimicrobial chemotherapy (J Antimicrob Chemother) Vol. 49 Issue 2 Pg. 367-71 (Feb 2002) ISSN: 0305-7453 [Print] England
• PMID: 11815581 (Publication Type: Comparative Study, Journal Article)

Chemical References

• Anti-Infective Agents, Urinary
• Amoxicillin-Potassium Clavulanate Combination

Topics

• Aged
• Aged, 80 and over
• Amoxicillin-Potassium Clavulanate Combination (adverse effects, pharmacology)
• Anti-Infective Agents, Urinary (adverse effects, pharmacology)
• Confidence Intervals
• Drug Resistance, Multiple, Bacterial (physiology)
• Escherichia coli Infections (drug therapy, microbiology)
• Humans
• Infant
• Middle Aged
• Risk Factors
• Urinary Tract Infections (drug therapy, microbiology)