Fluoroquinolone Use and Seasonal Patterns of Ciprofloxacin Resistance in Community-acquired Urinary Escherichia coli in a Large Urban Center.

Fluoroquinolone Use and Seasonal Patterns of Ciprofloxacin Resistance in Community-acquired Urinary Escherichia coli in a Large Urban Center. Am J Epidemiol. 2019 Oct 29;: Authors: Soucy JR, Schmidt AM, Quach C, Buckeridge DL Abstract Urinary tract infections caused by the bacteria Escherichia coli are among the most frequently encountered infections and a common reason for antimicrobial prescriptions. Resistance to fluoroquinolone antimicrobials, and in particular ciprofloxacin, has increased in recent decades. It is intuitive that variation in resistance is driven by changes in antimicrobial use, but careful study of this association requires the use of time-series methods. We studied seasonal variation in ciprofloxacin, trimethoprim-sulfamethoxazole, and ampicillin resistance in community-acquired urinary E. coli isolates in Montreal, Quebec, Canada between April 2010 and December 2014. Using dynamic linear models, we investigated whether seasonal variation in resistance could be explained by seasonal variation in community antimicrobial use. We found a positive association between total fluoroquinolone use lagged by 1 and 2 months and the proportion of isolates resistant to ciprofloxacin. Our results suggest that resistance to ciprofloxacin is responsive to short-term variation in antimicrobial use. Thus, antimicrobial stewardship campaigns to reduce fluoroquinolone use, particularly in the winter when fluoroquinolone use is high...
Source: Am J Epidemiol - Category: Epidemiology Authors: Tags: Am J Epidemiol Source Type: research