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Volume 10, Number 1—January 2004

Research

Fluoroquinolones Protective against Cephalosporin Resistance in Gram-negative Nosocomial Pathogens

Mitchell J. Schwaber*1Comments to Author , Sara E. Cosgrove*2, Howard S. Gold*, Keith S. Kaye†, and Yehuda Carmeli*‡
Author affiliations: *Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA; †Duke University Medical Center, Durham, North Carolina, USA; ‡Tel Aviv Sourasky Medical Center, Tel Aviv, Israel

Main Article

Table 1

Characteristics of study patients and univariate analysis of outcomea

Characteristic Case-patients (n = 282) (%) Controls (n = 562) (%) HR (95% CI)b p
Mean age (y) 62.4 62.1 1.00 (0.99 to 1.01) 0.82
Male 156 (55.3) 296 (52.7) 1.12 (0.84 to 1.50) 0.44
No. of coexisting conditions 0:14 (5.0) 0:47 (8.4) 1.22 (1.04 to 1.44) 0.01
1:71 (25.2) 1:155 (27.6)
2:111 (39.4) 2:228 (40.6)
>3:86 (30.5) >3:132 (23.5)
AIDS 1 (0.4) 13 (2.3) 0.15 (0.02 to 1.18) 0.07
Cardiovascular disease 205 (72.7) 404 (71.9) 1.04 (0.80 to 1. 43) 0.81
Diabetes mellitus 124 (44.0) 259 (46.1) 0.92 (0.69 to 1.23) 0.57
Hepatic disease 66 (23.4) 86 (15.3) 1.70 (1.18 to 2.44) 0.004
Pulmonary disease 48 (17.0) 67 (11.9) 1.52 (1.01 to 2.28) 0.04
Renal disease 68 (24.1) 88 (15.7) 1.71 (1.20 to 2.44) 0.003
In intensive care unit during risk period 161 (57.1) 207 (36.8) 2.65 (1.91 to 3.68) < 0.001
Malignancy 46 (16.3) 92 (16.4) 0.99 (0.67 to 1.47) 0.97
Surgery during risk period 164 (58.2) 229 (40.8) 2.03 (1.50 to 2.73) < 0.001
Receipt of β-lactam/
β-lactamase inhibitor 111 (39.4) 125 (22.2) 2.48 (1.77 to 3.49) < 0.001
Receipt of aminoglycoside 62 (22.0) 97 (17.3) 1.39 (0.95 to 2.04) 0.09
Receipt of 1st- or 2nd-generation cephalosporin 117 (41.5) 195 (34.7) 1.39 (1.01 to 1.92) 0.04
Receipt of third-generation cephalosporin 114 (40.4) 122 (21.7) 2.98 (2.07 to 4.27) < 0.001
Receipt of imipenem 27 (9.6) 37 (6.6) 1.51 (0.87 to 2.62) 0.14
Receipt of ureidopenicillin 42 (14.9) 32 (5.7) 2.91 (1.77 to 4.77) < 0.001
Receipt of fluoroquinolone 23 (8.2) 79 (14.1) 0.48 (0.28 to 0.82) 0.008

aOutcome refers to the isolation of third-generation cephalosporin-resistant Enterobacter spp., Pseudomonas aeruginosa, or Klebsiella pneumoniae from a clinical specimen.
bHR, hazard ratio; CI, confidence interval.

Main Article

1Current affiliation: Epidemiology Unit, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.

2Current affiliation: Division of Infectious Disease, Johns Hopkins Hospital, Baltimore, Maryland, USA.

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