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  • 1
    Keywords: Germany ; screening ; RISK ; SAMPLE ; SAMPLES ; INFECTION ; IMPACT ; RISK-FACTORS ; ASSOCIATION ; HEALTH ; DESIGN ; ESCHERICHIA-COLI ; resistance ; risk factors ; CHILDREN ; INFECTIONS ; PREVALENCE ; YOUNG ; ASSOCIATIONS ; RE ; SIBLINGS ; DETERMINANTS ; RESISTANT ; odds ratio ; RISK-FACTOR ; population-based ; E ; TRANSMISSION ; COMMUNITY ; CONTACT ; HEALTHY-CHILDREN ; URINARY-TRACT-INFECTION ; bacterial ; antibiotic resistance ; ANTIBIOTIC-RESISTANCE ; DAY-CARE-CENTERS ; e.coli ; household ; TRIMETHOPRIM-RESISTANT
    Abstract: Objective: In young children infections with resistant Escherichia coli (E. coli) can lead to life-threatening situations. Epidemiological data on the prevalence and major determinants of carriage of antibiotic resistant E. coli among children in the community setting are sparse. Study Design and Setting: In a population-based study from Germany, stool samples were obtained from children aged 6 months to 4 years attending a pediatrician for a regular health screening (N = 568) or an acute infection (N = 316), as well as from their parents (N = 1,594) and siblings (N = 624). E coli was cultured, and minimal inhibitory concentrations to various antibiotics were tested. We determined prevalences of E. coli resistance to commonly prescribed antibiotics and their association with potential risk factors. Results: Prevalence of E. coli resistance was 16.6%, 8.7%, and 11.6% for ampicillin, cotrimoxazole, and doxycycline, respectively. Strong associations were found with antibiotic resistance among siblings (odds ratios [95% confidence intervals] for ampicillin, doxycycline, and cotrimoxazole resistance: 4.4 [1.8-10.81, 8.0 [3.0-21.2], and 10.8 [3.5-32.71, respectively). Conclusion: Resistance prevalences in this community-based study were much lower than those reported from the clinical sector. Household contacts seem to be the key factor for children's colonization with resistant E. coli in the community setting. (C) 2007 Elsevier Inc. All rights reserved
    Type of Publication: Journal article published
    PubMed ID: 17938057
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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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