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Volume 12, Number 6—June 2006

Dispatch

Class 1 Integrons in Resistant Escherichia coli and Klebsiella spp., US Hospitals

Aarati N. Rao*1, Miriam Barlow*2, Leigh Ann Clark†, John R. Boring*, Fred C. Tenover†, and John E. McGowan*Comments to Author 
Author affiliations: *Emory University, Atlanta, Georgia, USA; †Centers for Disease Control and Prevention, Atlanta, Georgia, USA

Main Article

Table 2

Association of nonsusceptibility to various antimicrobial agents and presence of integrons in Escherichia coli and Klebsiella spp. (Klebsiella pneumoniae and K. oxytoca)*

Antimicrobial drug Estimate OR (95% CI) p value†
E. coli
Gentamicin‡ 1.16 3.19 (1.40–7.30) 0.006
Ciprofloxacin 0.31 1.37 (0.46–4.03) 0.573
Ceftazidime –0.81 0.45 (0.14–1.45) 0.180
Cefepime –1.77 0.17 (0.04–0.82) 0.027
Piperacillin-tazobactam –0.38 0.68 (0.28–1.66) 0.407
Aztreonam 1.19 3.29 (0.90–12.0) 0.071
Chloramphenicol 0.29 1.34 (0.60–2.99) 0.476
Minocycline –0.11 0.89 (0.39–2.06) 0.791
Trimethoprim-sulfamethoxazole‡ 2.56 12.9 (5.73–29.0) <0.001
Source§ 1.10 3.02 (1.23–7.45) 0.02
Intercept –2.43 <0.0001
Klebsiella spp.
Gentamicin 1.44 4.23 (1.48–12.03) 0.007
Ciprofloxacin 0.34 1.40 (0.43–4.56) 0.578
Ceftazidime 0.92 2.51 (0.49–12.80) 0.270
Cefepime 0.05 1.05 (0.27–4.14) 0.942
Piperacillin-tazobactam 0.02 1.02 (0.26–4.07) 0.979
Aztreonam –1.64 0.19 (0.04–0.99) 0.048
Chloramphenicol –0.57 0.57 (0.13–2.44) 0.447
Minocycline 0.13 1.14 (0.35–3.73) 0.835
Trimethoprim-sulfamethoxazole 1.52 4.61 (1.39–15.29) 0.012
Source§ 0.56 1.75 (0.64–4.78) 0.275
Intercept –0.28 0.591

*Multivariate logistic regression with variables included for 1 drug of each major class that was tested. Hosmer and Lemeshow goodness-of-fit test statistic: E. coli total χ2 = 10.852, df = 8, p = 0.21; Klebsiella spp. total χ2 = 4.538, df = 8, and p = 0.81. OR, odds ratio; CI, confidence interval.
†By χ2 approximation.
‡Significant interaction between these 2 variables (p<0.001).
§Nonurine source vs. urine source (reference).

Main Article

1Current affiliation: Midwestern University, Glendale, Arizona, USA

2Current affiliation: University of California at Merced, Merced, California, USA

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