Epidemiology of Ciprofloxacin Resistance and Its Relationship to Extended-Spectrum beta-Lactamase Production in Proteus mirabilis Bacteremia.
10.3904/kjim.2011.26.1.89
- Author:
Kyung Mok SOHN
1
;
Cheol In KANG
;
Eun Jeong JOO
;
Young Eun HA
;
Doo Ryeon CHUNG
;
Kyong Ran PECK
;
Nam Yong LEE
;
Jae Hoon SONG
Author Information
1. Division of Infectious Diseases, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. collacin@hotmail.com
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Proteus mirabilis;
Ciprofloxacin;
Drug resistance;
Bacterial;
Risk factors;
Cephalosporin resistance
- MeSH:
Adult;
Aged;
Anti-Infective Agents/*pharmacology;
Bacteremia/*drug therapy;
Ciprofloxacin/*pharmacology;
Drug Resistance, Bacterial;
Female;
Humans;
Male;
Middle Aged;
Proteus Infections/*drug therapy;
Proteus mirabilis/*drug effects/enzymology;
Risk Factors;
beta-Lactamases/*biosynthesis
- From:The Korean Journal of Internal Medicine
2011;26(1):89-93
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND/AIMS: We evaluated the clinical features of ciprofloxacin-resistant Proteus mirabilis bacteremia and risk factors for ciprofloxacin resistance. METHODS: From October 2000 to July 2009, 37 patients with clinically significant P. mirabilis bacteremia were identified and data from patients with ciprofloxacin-resistant and ciprofloxacin-susceptible P. mirabilis bacteremia were compared. RESULTS: The most common underlying diseases were neurologic disease (37.8%) and solid tumors (29.7%). The most common site of infection was the urinary tract (35.1%). Ten of the 37 patients (27.0%) were infected with ciprofloxacin-resistant isolates, and univariate analysis revealed a significant relationship between ciprofloxacin-resistant P. mirabilis bacteremia and neurologic disease, recent operation, L-tube insertion, percutaneous tube use, and extended-spectrum beta-lactamase (ESBL) production (all p < 0.05). ESBL was detected in six of 10 (60%) ciprofloxacin-resistant isolates, while only three of 27 (11%) ciprofloxacin-susceptible isolates produced ESBL (p = 0.005). In a logistic regression analysis, ESBL production remained a significant factor associated with ciprofloxacin resistance, after adjusting for other variables. CONCLUSIONS: These data indicate a close association between ciprofloxacin resistance and ESBL-production in P. mirabilis bacteremia. This association is particularly troublesome because the therapeutic options for serious infections caused by ESBL-producing P. mirabilis are severely restricted.
