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Volume 22, Number 9—September 2016

CME ACTIVITY - Research

Fluoroquinolone-Resistant and Extended-Spectrum β-Lactamase–Producing Escherichia coli Infections in Patients with Pyelonephritis, United States1

David A. TalanComments to Author , Sukhjit S. Takhar, Anusha Krishnadasan, Fredrick M. Abrahamian, William R. Mower, Gregory J. Moran, and EMERGEncy ID Net Study Group
Author affiliations: David Geffen School of Medicine at the University of California, Los Angeles (UCLA), Los Angeles, California, USA (D.A. Talan, A. Krishnadasan, F.M. Abrahamian, W.R. Mower, G.J. Moran); Olive View–UCLA Medical Center, Los Angeles (D.A. Talan, A. Krishnadasan, F.M. Abrahamian, G.J. Moran); Brigham and Women’s Hospital, Boston, Massachusetts, USA (S.S. Takhar); Harvard Medical School, Boston (S.S. Takhar); Ronald Reagan Medical Center, Los Angeles (W.R. Mower)

Main Article

Table 4

Factors associated with fluoroquinolone resistance among 453 US emergency department patients with pyelonephritis caused by Escherichia coli, July 2013–December 2014*

Factor Fluoroquinolone-resistance rate
 Relative risk (95% CI)
Factor present, no./total (%) Factor absent, no./total (%)
Complicated infection
 36/181 (19.9)
 17/272 (6.3)
 3.2 (1.8–5.8)
Prior antimicrobial drugs taken
Within past 60 d 24/94 (25.5) 29/359 (8.1) 3.2 (1.9–5.3)
Within past 2 d
 9/27 (33.3)
 44/426 (10.3)
 3.2 (1.6–5.8)
Prior fluoroquinolone use
Within past 60 d 12/19 (63.2) 41/434 (9.4) 6.7 (3.8–9.6)
Within past 2 d
 6/8 (75.0)
 47/445 (10.6)
 7.1 (3.2–9.4)
IV antimicrobial drugs within past 30 d 6/26 (23.1) 47/425 (11.1) 2.1 (0.8–4.3)
LTC within past 90 d 1/3 (33.3) 52/450 (11.6) 2.9 (0.2–7.8)
Admitted to hospital within 90 d 11/42 (26.2) 42/411 (10.2) 2.6 (1.3–4.6)
Travel outside United States within past 90 d
 5/17 (29.4)†
 48/436 (11.0)
 2.7 (1.0–5.5)
UTI resulting from fluoroquinolone-resistant E. coli
Within past year 7/9 (77.8) 46/444 (10.4) 7.5 (3.7–9.6)
Within past 90 d
 7/8 (87.5)
 46/445 (10.3)
 8.5 (4.3–9.8)
UTI resulting from ceftriaxone-resistant E. coli
Within past year 5/6 (83.3) 48/447 (10.7) 7.8 (3.3–9.4)
Within past 90 d 5/5 (100.0) 48/448 (10.7) 9.3 (4.1–9.3)

*Denominators differ because factors have a different distribution among the patient population. IV, intravenous; LTC, residence in a long-term care facility; UTI, urinary tract infection.
†Of the 5 patients that traveled outside the United States, 3 traveled to Mexico or Central America and 2 traveled to Asia.

Main Article

1Preliminary results of this research were presented at the 2014 IDWeek Meeting, Philadelphia, PA, USA, October 8–12, 2014.

Page created: August 11, 2016
Page updated: August 11, 2016
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