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Antibiotic use duri...
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Karlsson, Philip A.Uppsala universitet,Institutionen för medicinsk biokemi och mikrobiologi,Anestesiologi och intensivvård
(author)
Antibiotic use during coronavirus disease 2019 intensive care unit shape multidrug resistance bacteriuria : A Swedish longitudinal prospective study
- Article/chapterEnglish2023
Publisher, publication year, extent ...
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2023-02-07
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Frontiers Media S.A.2023
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electronicrdacarrier
Numbers
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LIBRIS-ID:oai:DiVA.org:uu-496102
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https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-496102URI
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https://doi.org/10.3389/fmed.2023.1087446DOI
Supplementary language notes
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Language:English
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Summary in:English
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Classification
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
Notes
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Objectives: High frequency of antimicrobial prescription and the nature of prolonged illness in COVID-19 increases risk for complicated bacteriuria and antibiotic resistance. We investigated risk factors for bacteriuria in the ICU and the correlation between antibiotic treatment and persistent bacteria.Methods: We conducted a prospective longitudinal study with urine from indwelling catheters of 101 ICU patients from Uppsala University Hospital, Sweden. Samples were screened and isolates confirmed with MALDI-TOF and whole genome sequencing. Isolates were analyzed for AMR using broth microdilution. Clinical data were assessed for correlation with bacteriuria.Results: Length of stay linearly correlated with bacteriuria (R2 = 0.99, p ≤ 0.0001). 90% of patients received antibiotics, primarily the beta-lactams (76%) cefotaxime, piperacillin-tazobactam, and meropenem. We found high prevalence of Enterococcus (42%) being associated with increased cefotaxime prescription. Antibiotic-susceptible E. coli were found to cause bacteriuria despite concurrent antibiotic treatment when found in co-culture with Enterococcus.Conclusion: Longer stays in ICUs increase the risk for bacteriuria in a predictable manner. Likely, high use of cefotaxime drives Enterococcus prevalence, which in turn permit co-colonizing Gram-negative bacteria. Our results suggest biofilms in urinary catheters as a reservoir of pathogenic bacteria with the potential to develop and disseminate AMR.
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Added entries (persons, corporate bodies, meetings, titles ...)
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Pärssinen, JuliaUppsala universitet,Institutionen för medicinsk biokemi och mikrobiologi(Swepub:uu)jupa1332
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Danielsson, Erik A.Uppsala universitet,Anestesiologi och intensivvård(Swepub:uu)erida939
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Fatsis-Kavalopoulos, NikosUppsala universitet,Institutionen för medicinsk biokemi och mikrobiologi(Swepub:uu)nikka309
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Frithiof, RobertUppsala universitet,Anestesiologi och intensivvård(Swepub:uu)robfr118
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Hultström, Michael,1978-Uppsala universitet,Integrativ Fysiologi,Anestesiologi och intensivvård(Swepub:uu)mihul498
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Lipcsey, MiklósUppsala universitet,Hedenstiernalaboratoriet(Swepub:uu)milip123
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Järhult, Josef D.,1975-Uppsala universitet,Infektionsmedicin(Swepub:uu)josja939
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Wang, HelenUppsala universitet,Institutionen för medicinsk biokemi och mikrobiologi(Swepub:uu)helwa249
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Uppsala universitetInstitutionen för medicinsk biokemi och mikrobiologi
(creator_code:org_t)
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In:Frontiers in Medicine: Frontiers Media S.A.102296-858X
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