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  • ATTENDING GENERAL-PRACTITIONERS  (2)
Keywords
  • 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: EPIDEMIOLOGY ; IMPACT ; ATTENDING GENERAL-PRACTITIONERS ; INTESTINAL MICROFLORA ; stool samples ; Escherichia coli ; antibiotic resistance ; response to treatment ; AMOXICILLIN ; faecal flora ; FECAL FLORA ; outpatients
    Abstract: There is worldwide concern about the appearance and rise of bacterial resistance to commonly used antibiotics. Although the gut is an important reservoir for resistant Escherichia coli, data from large-scale epidemiological studies concerning the colonisation dynamics of the normal gut flora with resistant E. coli during and after antibiotic therapy are sparse. Accordingly, a large community-based study was conducted to ascertain changes in the prevalence of resistant E. coli during and after antibiotic treatment. Stool samples before, during and after antibiotic therapy were obtained from 541 patients (aged 〉= 40 years) with a febrile infection who attended a general practitioner in southern Germany. The MICs of commonly prescribed antibiotics for E. coli isolates from the stools were determined. The prevalence of resistance to the corresponding antibiotics rose from 18% to 38%, from 29% to 58% and from 33% to 67% during treatment with beta-lactam antibiotics, doxycycline and co-trimoxazole, respectively. Prevalences of resistance in the E. coli isolates also rose for other antibiotic classes. With the exception of co-trimoxazole resistance, prevalences of resistance returned to baseline levels in 〈 2 weeks after the cessation of antibiotic therapy. Thus, there was a substantial, but rapidly reversible, increase in the prevalence of resistant E. coli isolates during antibiotic treatment
    Type of Publication: Journal article published
    PubMed ID: 18005177
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