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Within-Population D...
Within-Population Distribution of Trimethoprim Resistance in Escherichia coli before and after a Community-Wide Intervention on Trimethoprim Use
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- Sundqvist, Martin, 1974- (författare)
- Uppsala universitet,Region Örebro län,Department of Clinical Microbiology, Central Hospital, Växjö, Sweden; Department of Medical Sciences, Division of Infectious Diseases, Uppsala University, Uppsala, Uppsala, Sweden; Department of Laboratory Medicine, Clinical Microbiology, University Hospital, Örebro, Sweden,Infektionssjukdomar
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- Granholm, Susanne (författare)
- Umeå universitet,Institutionen för klinisk mikrobiologi
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- Naseer, Umaer (författare)
- Dept Microbiol & Infect Control, Reference Ctr Detect Antimicrobial Resistance, Univ Hosp North Norway, Tromsø, Norway; Dept Med Biol, Res Grp Host Microbe Interact, Univ Tromsø, Tromsø, Norway
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- Rydén, Patrik (författare)
- Umeå universitet,Institutionen för matematik och matematisk statistik
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- Brolund, Alma (författare)
- Publ Hlth Agcy Sweden, Solna, Sweden; Dept Microbiol Tumor & Cell Biol, Karolinska Inst, Stockholm, Sweden
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- Sundsfjord, Arnfinn (författare)
- Dept Microbiol & Infect Control, Reference Ctr Detect Antimicrobial Resistance, Univ Hosp North Norway, Tromsø, Norway; Dept Med Biol, Res Grp Host Microbe Interact, Univ Tromsø, Tromsø, Norway
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- Kahlmeter, Gunnar (författare)
- Uppsala universitet,Klinisk bakteriologi
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- Johansson, Anders (författare)
- Umeå universitet,Institutionen för klinisk mikrobiologi
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(creator_code:org_t)
- American Society for Microbiology, 2014
- 2014
- Engelska.
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Ingår i: Antimicrobial Agents and Chemotherapy. - : American Society for Microbiology. - 0066-4804 .- 1098-6596. ; 58:12, s. 7492-7500
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Abstract
Ämnesord
Stäng
- A 2-year prospective intervention on the prescription of trimethoprim reduced the use by 85% in a health care region with 178,000 inhabitants. Here, we performed before-and-after analyses of the within-population distribution of trimethoprim resistance in Escherichia coli. Phylogenetic and population genetic methods were applied to multilocus sequence typing data of 548 consecutively collected E. coli isolates from clinical urinary specimens. Results were analyzed in relation to antibiotic susceptibility and the presence and genomic location of different trimethoprim resistance gene classes. A total of 163 E. coli sequence types (STs) were identified, of which 68 were previously undescribed. The isolates fell into one of three distinct genetic clusters designated BAPS 1 (E. coli phylogroup B2), BAPS 2 (phylogroup A and B1), and BAPS 3 (phylogroup D), each with a similar frequency before and after the intervention. BAPS 2 and BAPS 3 were positively and BAPS 1 was negatively associated with trimethoprim resistance (odds ratios of 1.97, 3.17, and 0.26, respectively). In before-and-after analyses, trimethoprim resistance frequency increased in BAPS 1 and decreased in BAPS 2. Resistance to antibiotics other than trimethoprim increased in BAPS 2. Analysis of the genomic location of different trimethoprim resistance genes in isolates of ST69, ST58, and ST73 identified multiple independent acquisition events in isolates of the same ST. The results show that despite a stable overall resistance frequency in E. coli before and after the intervention, marked within-population changes occurred. A decrease of resistance in one major genetic cluster was masked by a reciprocal increase in another major cluster.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Medicinska och farmaceutiska grundvetenskaper -- Mikrobiologi inom det medicinska området (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Basic Medicine -- Microbiology in the medical area (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Medicinska och farmaceutiska grundvetenskaper -- Farmakologi och toxikologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Basic Medicine -- Pharmacology and Toxicology (hsv//eng)
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