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  • 1
    Keywords: Germany ; INHIBITION ; THERAPY ; RISK ; RISK-FACTORS ; resistance ; WOMEN ; MEN ; risk factors ; PREVALENCE ; HOSPITALIZATION ; RE ; ANTIBIOTICS ; RESISTANT ; odds ratio ; RISK-FACTOR ; TRANSMISSION ; COMMUNITY ; BACTERIA ; ATTENDING GENERAL-PRACTITIONERS ; HOSPITALS ; TRIMETHOPRIM ; URINARY-TRACT-INFECTIONS
    Abstract: Background: Spread of antibiotic resistance in hospitals is a well-known problem, but studies investigating the importance of factors potentially related to the spread of resistant bacteria in outpatients are sparse. Methods: Stool samples were obtained from 206 healthy couples in a community setting in Southern Germany in 2002 - 2003. E. coli was cultured and minimal inhibition concentrations were tested. Prevalences of E. coli resistance to commonly prescribed antibiotics according to potential risk factors were ascertained. Results: Prevalences of ampicillin resistance were 15.7% and 19.4% for women and men, respectively. About ten percent and 15% of all isolates were resistant to cotrimoxazole and doxycycline, respectively. A partner carrying resistance was the main risk factor for being colonized with resistant E. coli. Odds ratios (95% CI) for ampicillin and cotrimoxazole resistance given carriage of resistant isolates by the partner were 6.9 (3.1 - 15.5) and 3.3 (1.5 - 18.0), respectively. Conclusion: Our data suggest that conjugal transmission may be more important for the spread of antibiotic resistance in the community setting than commonly suspected risk factors such as previous antibiotic intake or hospital contacts
    Type of Publication: Journal article published
    PubMed ID: 16848901
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  • 2
    Keywords: AGENTS ; Germany ; EPIDEMIOLOGY ; SAMPLES ; PATIENT ; culture ; PATTERNS ; HUMANS ; resistance ; PREVALENCE ; ADULT ; methods ; drug therapy ; pharmacology ; FECES ; female ; Male ; ANTIBIOTICS ; RESISTANT ; E ; microbiology ; Aged ; Middle Aged ; isolation & purification ; Ampicillin ; Anti-Bacterial Agents ; Ciprofloxacin ; Doxycycline ; drug effects ; Drug Resistance,Multiple,Bacterial ; Enterococcus faecalis ; Enterococcus faecium ; Gram-Positive Bacterial Infections ; growth & development ; Microbial Sensitivity Tests
    Abstract: PURPOSE: The aim of the study was to assess the prevalence and determinants of antibiotic-resistant Enterococci in a large group of outpatients in Southern Germany. METHODS: Stool samples were collected from 497 unselected patients aged 40-75 years attending general practitioners. Enterococcus faecium (E. faecium) and Enterococcus faecalis (E. faecalis) were cultured and minimal inhibitory concentrations of antibiotics used inside and outside the clinical sector were tested. RESULTS: E. faecium and E. faecalis could be identified and cultured in 60 (12.4%) and 205 (41.2%) of the stool samples, respectively. Under non-selective culture conditions no vancomycin-resistant Enterococcus (VRE) isolate was found. Only E. faecium isolates showed resistance to fluoroquinolones, 40% were resistant to ciprofloxacin. The prevalences of E. faecium resistance to ampicillin and doxycycline were 3.3% and 13.3%, respectively, whereas 0.5% and 29.6% of the E. faecalis isolates were resistant to ampicillin and doxycycline, respectively. Antibiotic use during the last 3 months was significantly associated with antibiotic resistance (to either ampicillin, imipenem, or doxycycline) of E. faecalis isolates (OR: 2.9; CI: 1.2-6.8). CONCLUSIONS: Prevalences of resistance were generally lower than and patterns of resistance were quite different from previous investigations in the clinical setting. Recent antibiotic use was associated with increased colonization with resistant strains
    Type of Publication: Journal article published
    PubMed ID: 16287198
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