Effect of excluding duplicate isolates of Escherichia coli and Staphylococcus aureus in a 14 year consecutive database

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Sundqvist, MartinUppsala universitet,Infektionssjukdomar (författare)

Effect of excluding duplicate isolates of Escherichia coli and Staphylococcus aureus in a 14 year consecutive database

Artikel/kapitelEngelska2007

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2007-03-01
Oxford University Press (OUP),2007
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LIBRIS-ID:oai:DiVA.org:uu-112600
https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-112600URI
https://doi.org/10.1093/jac/dkm040DOI

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Språk:engelska
Sammanfattning på:engelska

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OBJECTIVES: It is recommended that duplicate isolates are excluded when reporting resistance rates. The rationale for this is that failing to do so will yield falsely high resistance rates. We analysed a 14 year consecutive database of Escherichia coli (n=62,380) and Staphylococcus aureus (n=28,178) using various cut-off algorithms to determine the importance of excluding duplicates and principal differences between the bacteria. METHODS: Susceptibility testing was performed according to the Swedish Reference Group for Antibiotics guidelines. Duplicates were excluded on the basis of species, individual and time (exclusion cut-offs of 7, 14, 30, 45, 90, 180, 270 and 365 days) from the first isolate. RESULTS: Although 30% of the isolates were excluded using a 365 day exclusion algorithm, the effects on resistance rates of excluding duplicates were small. Irrespective of cut-off, resistance in S. aureus decreased when duplicates were excluded. Using 7-30 days cut-offs, resistance in E. coli decreased or was not affected, whereas higher resistance rates were obtained when exclusion was based on a 365 day cut-off. Fluoroquinolone resistance was a clear exception to this rule. CONCLUSIONS: Although the effect of exclusion of duplicates was minor, we suggest that exclusion cut-offs should match the study timeline. The data presented on E. coli, from urinary tract infections, and S. aureus, from skin and soft tissue infections, suggest that E. coli infection, >90 days after the first culture, is mainly caused by new less-resistant strains. Patients with S. aureus continue to be colonized with the same strain.

Ämnesord och genrebeteckningar

antimicrobial resistance
surveillance
urinary tract infections
skin and soft tissue infections
MEDICINE
MEDICIN

Biuppslag (personer, institutioner, konferenser, titlar ...)

Kahlmeter, GunnarUppsala universitet,Klinisk bakteriologi(Swepub:uu)gunka977 (författare)
Uppsala universitetInfektionssjukdomar (creator_code:org_t)

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Ingår i:Journal of Antimicrobial Chemotherapy: Oxford University Press (OUP)59:5, s. 913-9180305-74531460-2091

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