TY  - JOUR
TI  - Trends and Risk Factors for Ciprofloxacin Resistance and Extendedspectrum Beta-lactamase Production in Uropathogens from Urology and Non-urology Outpatients
AB  - Objective: This study aimed to identify the patterns and temporal changes of ciprofloxacin resistance and extended-spectrum beta-lactamase(ESBL) production in uropathogenic isolates obtained from urology and non-urology outpatients.Materials and Methods: In this cross-sectional study, electronic data of urine culture and antimicrobial susceptibility test results of samplescollected in urology and non-urology outpatient departments from 2008 to 2016 were retrospectively analysed to identify correlations betweenbasic demographic features and clinical settings.Results: Escherichia coli (E. coli) was the most prevalent (70%) uropathogenic isolate in a cohort of 7.973 patients consisting of 82.8% women,70.7% adults and 15.7% urology outpatients. Overall, resistance to ciprofloxacin was found in 16.3% of the patients. Ciprofloxacin resistance wasassociated with being male and old, observed more frequently in urology outpatients, detected in 19.2% of E. coli isolates and increased to 54.5%among ESBL-producing bacterial strains (p<0.05). ESBL production was observed in 12% of all isolates. Increased ESBL production was associatedwith old age and isolates of E. coli and Klebsiella spp. (p<0.05). Statistical analysis using multivariate generalised linear mixed models (mGLMMs) toassess the relationship between the outcomes predicted a significantly higher ESBL production in E. coli and Klebsiella spp. isolates and in geriatricpatients. Furthermore, mGLMM analysis predicted a significantly increased likelihood of ciprofloxacin resistance in older adult male patients,especially in E. coli and Enterococcus spp. isolates. Moreover, a high rate of ESBL production was observed, reaching over 15% in 2015 (p<0.05).The rates of ciprofloxacin resistance remained >10% and peaked in 2015 (20.2%, p<0.001). However, in 2016, the rate of ESBL production andciprofloxacin resistance started to decline, displaying significance only regarding the latter (p<0.05).Conclusion: Empirical ciprofloxacin treatment of community-acquired urinary tract infections carries a higher risk of an unsuccessful outcomein male, geriatric and urology outpatients. Empirical antibacterial therapy for urological infections in the outpatient setting should be conductedbased on patient risk profiles and contemporary local resistance data.
AU  - NARTER, Kamil Fehmi
AU  - ÖZVEREN, Bora
AU  - ŞAHİN, Ahmet
AU  - Türkeri, Levent
PY  - 2021
JO  - Journal of Urological Surgery
VL  - 8
IS  - 2
SN  - 2148-9580
SP  - 135
EP  - 141
DB  - TRDizin
UR  - http://search/yayin/detay/454023
ER  -