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APMIS : Acta Pathologica,... Mar 2020The aim of this study was to identify microbial risk factors for treatment failure of pivmecillinam in community-acquired urinary tract infections (ca-UTIs) caused by...
The aim of this study was to identify microbial risk factors for treatment failure of pivmecillinam in community-acquired urinary tract infections (ca-UTIs) caused by ESBL-producing Escherichia coli. Eighty-nine ESBL-producing E. coli isolated from women suffering from ca-UTIs were included. The susceptibilities to mecillinam were determined using MIC gradient strip. Whole genome sequencing was performed on a MiSeq platform, and genome assembly was performed using SPAdes v3.11.0. Neither mecillinam MICs nor ESBL genotypes were associated with treatment outcome of patients treated with pivmecillinam. Specific STs, however, showed significant differences in treatment outcome. Patients infected with ST131 were more likely to experience treatment failure compared to patients infected with non-ST131 (p 0.02) when adjusted for pivmecillinam dose, mecillinam MIC and severity of infection. Patients infected with ST69 were more often successfully treated compared to patients infected with non-ST69 (p 0.04). Patients infected with bla ST131 strains were more likely to experience treatment failure than those infected with non-bla ST131 strains (p 0.02). The results suggest that specific STs are associated with the clinical efficacy of pivmecillinam. Further studies with a larger number of strains, including a larger number of mecillinam resistant strains, are needed to confirm these results.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Amdinocillin Pivoxil; Anti-Bacterial Agents; Community-Acquired Infections; Escherichia coli; Escherichia coli Infections; Escherichia coli Proteins; Female; Humans; Microbial Sensitivity Tests; Middle Aged; Risk Factors; Treatment Failure; Treatment Outcome; Urinary Tract; Urinary Tract Infections; Young Adult; beta-Lactamases
PubMed: 31755584
DOI: 10.1111/apm.13013 -
Scandinavian Journal of Primary Health... Mar 2020
Topics: Adolescent; Adult; Amdinocillin Pivoxil; Anti-Bacterial Agents; Denmark; Escherichia coli; Humans; Male; Middle Aged; Nitrofurantoin; Prescriptions; Retrospective Studies; Trimethoprim; Urinary Tract Infections; Young Adult
PubMed: 31997687
DOI: 10.1080/02813432.2020.1718301