WFRF:(Kahlmeter Gunnar)
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Effect of excluding duplicate isolates of Escherichia coli and Staphylococcus aureus in a 14 year consecutive database
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- Sundqvist, Martin (författare)
- Uppsala universitet,Infektionssjukdomar
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- Kahlmeter, Gunnar (författare)
- Uppsala universitet,Klinisk bakteriologi
- (creator_code:org_t)
- 2007-03-01
- 2007
- Engelska.
- Ingår i: Journal of Antimicrobial Chemotherapy. - : Oxford University Press (OUP). - 0305-7453 .- 1460-2091. ; 59:5, s. 913-918
- Tidskriftsartikel (refereegranskat)
Abstract
Ämnesord
Stäng
- 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.
Nyckelord
- antimicrobial resistance
- surveillance
- urinary tract infections
- skin and soft tissue infections
- MEDICINE
- MEDICIN
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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