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  • DKFZ Publication Database  (5)
  • 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: 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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  • 3
    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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  • 4
    Keywords: Germany ; human ; POPULATION ; SUSCEPTIBILITY ; DESIGN ; ESCHERICHIA-COLI ; resistance ; COUNTRIES ; POPULATIONS ; PREVALENCE ; RE ; INCREASE ; PATHOGENS ; E ; COMMUNITY ; animal ; TRIMETHOPRIM ; ANTIMICROBIAL SURVEILLANCE PROGRAM ; EMERGENCE ; HEALTHY-CHILDREN ; NONHOSPITALIZED PATIENTS ; SPECTRUM BETA-LACTAMASES ; URINARY-TRACT-INFECTION
    Abstract: The increase in bacterial antibiotic resistance is of major concern worldwide, but pertinent epidemiologic studies have used strongly divergent approaches and are widely scattered in the literature. The aim of this study was to conduct a systematic review of studies reporting on the prevalence of antibiotic resistance in Escherichia coli in different parts of the world. Studies published from 1970 to 2006 on the prevalence of E. coli resistance were identified by a systematic Medline research and reviewed with respect to characteristics of the study design and study population, the method of resistance detection, and the prevalence of resistance. The prevalence of resistance to specific antibiotics was highly variable in different populations and in different countries and ranged from 0 to 100%. The prevalence of resistance reported in studies from Middle and South America, Spain, and Turkey was higher than that reported in the USA and Central Europe. Moreover, a tendency towards higher prevalence rates of resistance in recent years was observed. The findings indicate a need for regular monitoring of antimicrobial susceptibility rates in different human and animal populations by standardized sampling and measurement procedures. Such monitoring would help identify relevant factors that contribute to the spread of resistant pathogens and would support the prudent use of antibiotics
    Type of Publication: Journal article published
    PubMed ID: 17235554
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  • 5
    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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