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Antimicrobial-resistant invasive Escherichia coli, Spain.
Jesús Oteo1, Edurne Lázaro, Francisco J de Abajo
1Instituto de Salud Carlos III, Madrid, Spain.
Emerging Infectious Diseases
|April 15, 2005
Summary
Antimicrobial resistance in invasive Escherichia coli is rising in Spain, with multi-drug resistance increasing significantly. This trend occurred despite reduced antibiotic use, highlighting complex factors driving resistance patterns.
Area of Science:
- Clinical Microbiology
- Infectious Diseases
- Public Health Surveillance
Background:
- Invasive Escherichia coli infections pose a significant public health threat.
- Monitoring antimicrobial resistance patterns is crucial for effective treatment strategies.
- Understanding the relationship between antimicrobial consumption and resistance is essential.
Purpose of the Study:
- To analyze antimicrobial susceptibility trends of invasive Escherichia coli in Spain from 2001 to 2003.
- To investigate the correlation between antimicrobial usage and the prevalence of resistance.
- To identify emerging resistance mechanisms, such as extended-spectrum beta-lactamase (ESBL) production.
Main Methods:
- Utilized data from a surveillance system of 32 Spanish hospitals covering approximately 9.6 million individuals.
- Collected antimicrobial susceptibility data for 7,098 invasive Escherichia coli isolates.
- Obtained antimicrobial consumption data from the Spanish National Health System.
Main Results:
- High resistance rates were observed for ampicillin (59.9%), cotrimoxazole (32.6%), and ciprofloxacin (19.3%).
- Multi-drug resistance increased from 13.8% in 2001 to 20.6% in 2003 (p <0.0001).
- Extended-spectrum beta-lactamase (ESBL) production rose from 1.6% to 4.1% (p <0.0001), primarily due to cefotaximases, despite decreased cephalosporin and beta-lactam use.
- Ciprofloxacin resistance significantly increased, particularly in community-onset infections, correlating with increased quinolone use.
- Cotrimoxazole resistance remained stable around 30% despite reduced usage.
Conclusions:
- Invasive Escherichia coli exhibits increasing antimicrobial resistance and multi-drug resistance in Spain.
- Rising ESBL production and ciprofloxacin resistance suggest concerning trends in both hospital and community settings.
- The study underscores the complex interplay between antimicrobial use and resistance, necessitating ongoing surveillance and strategic interventions.