Fluoroquinolones Protective against Cephalosporin Resistance in Gram-negative Nosocomial Pathogens

Schwaber, Mitchell J.; Cosgrove, Sara E.; Gold, Howard S.; Kaye, Keith S.; Carmeli, Yehuda

doi:10.3201/eid1001.020663

i

Fluoroquinolones Protective against Cephalosporin Resistance in Gram-negative Nosocomial Pathogens

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Jan 2004
By Schwaber, Mitchell J. ; Cosgrove, Sara E. ; Gold, Howard S. ; ...

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English

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Alternative Title:

Emerg Infect Dis
Personal Author:

Schwaber, Mitchell J. ; Cosgrove, Sara E. ; Gold, Howard S. ; Kaye, Keith S. ; Carmeli, Yehuda
Description:

In a matched case-control study, we studied the effect of prior receipt of fluoroquinolones on isolation of three third-generation cephalosporin-resistant gram-negative nosocomial pathogens. Two hundred eighty-two cases with a third-generation cephalosporin-resistant pathogen (203 with Enterobacter spp., 50 with Pseudomonas aeruginosa, and 29 with Klebsiella pneumoniae) were matched on length of stay to controls in a 1:2 ratio. Case-patients and controls were similar in age (mean 62 years) and sex (54% male). Variables predicting third-generation cephalosporin resistance were surgery (p = 0.005); intensive care unit stay (p < 0.001); and receipt of a b-lactam/b-lactamase inhibitor (p < 0.001), a ureidopenicillin (p = 0.002), or a third-generation cephalosporin (p < 0.001). Receipt of a fluoroquinolone was protective against isolation of a third-generation cephalosporin-resistant pathogen (p = 0.005). Interventional studies are required to determine whether replacing third-generation cephalosporins with fluoroquinolones will be effective in reducing cephalosporin resistance and the effect of such interventions on fluoroquinolone resistance.
Subjects:

Case-Control Studies Cephalosporin Resistance Comorbidity Confidence Intervals Cross Infection Female Gram-Negative Bacteria Gram-Negative Bacterial Infections Humans Male Middle Aged Research
Source:

Emerg Infect Dis. 10(1):94-99.
Document Type:

Journal Article
Funding:

TO1/CCU111438/CC/ODCDC CDC HHS/United States
Volume:

10
Issue:

1
Collection(s):

Emerging Infectious Diseases
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urn:sha256:26a29f8ff489f4d8c0a6bb5f9874c910d30ff1d7e2a7f9db4147d741fdfae47e
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https://stacks.cdc.gov/view/cdc/14148/cdc_14148_DS1.pdf
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[PDF - 318.29 KB ]

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