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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 ...

  • 2023-02-07
  • Frontiers Media S.A.2023
  • electronicrdacarrier

Numbers

  • LIBRIS-ID:oai:DiVA.org:uu-496102
  • https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-496102URI
  • https://doi.org/10.3389/fmed.2023.1087446DOI

Supplementary language notes

  • Language:English
  • Summary in:English

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  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • 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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  • Pärssinen, JuliaUppsala universitet,Institutionen för medicinsk biokemi och mikrobiologi(Swepub:uu)jupa1332 (author)
  • Danielsson, Erik A.Uppsala universitet,Anestesiologi och intensivvård(Swepub:uu)erida939 (author)
  • Fatsis-Kavalopoulos, NikosUppsala universitet,Institutionen för medicinsk biokemi och mikrobiologi(Swepub:uu)nikka309 (author)
  • Frithiof, RobertUppsala universitet,Anestesiologi och intensivvård(Swepub:uu)robfr118 (author)
  • Hultström, Michael,1978-Uppsala universitet,Integrativ Fysiologi,Anestesiologi och intensivvård(Swepub:uu)mihul498 (author)
  • Lipcsey, MiklósUppsala universitet,Hedenstiernalaboratoriet(Swepub:uu)milip123 (author)
  • Järhult, Josef D.,1975-Uppsala universitet,Infektionsmedicin(Swepub:uu)josja939 (author)
  • Wang, HelenUppsala universitet,Institutionen för medicinsk biokemi och mikrobiologi(Swepub:uu)helwa249 (author)
  • Uppsala universitetInstitutionen för medicinsk biokemi och mikrobiologi (creator_code:org_t)

Related titles

  • In:Frontiers in Medicine: Frontiers Media S.A.102296-858X

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