title: Antimicrobial resistance in more than 100,000 Escherichia coli isolates according to culture site and patient age, gender, and location.
abstract: Escherichia coli and the antimicrobial pressure exerted on this microorganism can be modulated by factors dependent on the host. In this paper, we describe the distribution of antimicrobial resistance to amikacin, tobramycin, ampicillin, amoxicillin clavulanate, cefuroxime, cefoxitin, cefotaxime, imipenem, ciprofloxacin, fosfomycin, nitrofurantoin, and trimetoprim-sulfametoxazole in more than 100,000 E. coli isolates according to culture site and patient age, gender, and location. Bayesian inference was planned in all statistical analysis, and Markov chain Monte Carlo simulation was employed to estimate the model parameters. Our findings show the existence of a marked difference in the susceptibility to several antimicrobial agents depending on from where E. coli was isolated, with higher levels of resistance in isolates from medical devices, the respiratory system, and the skin and soft tissues; a higher resistance percentage in men than in women; and the existence of a clear difference in antimicrobial resistance with an age influence that cannot be explained merely by means of an increase of resistance after exposure to antimicrobials. Both men and women show increases in resistance with age, but while women show constant levels of resistance or slight increases during childbearing age and greater increases in the premenopausal age, men show a marked increase in resistance in the pubertal age. In conclusion, an overwhelming amount of data reveals the great adaptation capacity of E. coli and its close interaction with the host. Sex, age, and the origin of infection are determining factors with the ability to modulate antimicrobial resistances.
authors.affiliation: Hospital La Fe, Avda. Campanar 21, 46009 Valencia, Spain. wadjur@hotmail.com
authors.forename: José Miguel
authors.initials: JM
authors.lastname: Sahuquillo-Arce
authors.forename: María
authors.initials: M
authors.lastname: Selva
authors.forename: Hèctor
authors.initials: H
authors.lastname: Perpiñán
authors.forename: Miguel
authors.initials: M
authors.lastname: Gobernado
authors.forename: Carmen
authors.initials: C
authors.lastname: Armero
authors.forename: Antonio
authors.initials: A
authors.lastname: López-Quílez
authors.forename: Francisco
authors.initials: F
authors.lastname: González
authors.forename: Hermelinda
authors.initials: H
authors.lastname: Vanaclocha
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000583:Amikacin / Q000627:therapeutic use; D000667:Ampicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002439:Cefotaxime / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D002939:Ciprofloxacin / Q000627:therapeutic use; D024901:Drug Resistance, Multiple, Bacterial; D004926:Escherichia coli / Q000187:drug effects* / Q000472:pathogenicity*; D004927:Escherichia coli Infections / Q000188:drug therapy; D005260:Female; D005578:Fosfomycin / Q000627:therapeutic use; D006801:Humans; D015378:Imipenem / Q000627:therapeutic use; D007223:Infant; D008297:Male; D008875:Middle Aged; D009582:Nitrofurantoin / Q000627:therapeutic use; D012189:Retrospective Studies; D014031:Tobramycin / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D005578:Fosfomycin; D002939:Ciprofloxacin; D015378:Imipenem; D000667:Ampicillin; D000583:Amikacin; D009582:Nitrofurantoin; D002439:Cefotaxime; D014031:Tobramycin