Prediction of Fluoroquinolone Resistance in Gram-Negative Bacteria Causing Bloodstream Infections

Antimicrobial Agents and Chemotherapy
Seejil DanM N Al-Hasan

Abstract

Increasing rates of fluoroquinolone resistance (FQ-R) have limited empirical treatment options for Gram-negative infections, particularly in patients with severe beta-lactam allergy. This case-control study aims to develop a clinical risk score to predict the probability of FQ-R in Gram-negative bloodstream isolates. Adult patients with Gram-negative bloodstream infections (BSI) hospitalized at Palmetto Health System in Columbia, South Carolina, from 2010 to 2013 were identified. Multivariate logistic regression was used to identify independent risk factors for FQ-R. Point allocation in the fluoroquinolone resistance score (FQRS) was based on regression coefficients. Model discrimination was assessed by the area under receiver operating characteristic curve (AUC). Among 824 patients with Gram-negative BSI, 143 (17%) had BSI due to fluoroquinolone-nonsusceptible Gram-negative bacilli. Independent risk factors for FQ-R and point allocation in FQRS included male sex (adjusted odds ratio [aOR], 1.97; 95% confidence intervals [CI], 1.36 to 2.98; 1 point), diabetes mellitus (aOR, 1.54; 95% CI, 1.03 to 2.28; 1 point), residence at a skilled nursing facility (aOR, 2.28; 95% CI, 1.42 to 3.63; 2 points), outpatient procedure within 30 da...Continue Reading

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Citations

Dec 19, 2016·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·Matthew R AugustineMajdi N Al-Hasan
Feb 15, 2017·Antimicrobial Agents and Chemotherapy·Ansal ShahMajdi N Al-Hasan
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Oct 19, 2020·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Ohad Lewin-EpsteinUri Obolski
May 28, 2019·Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases·M N Al-Hasan, H Rac
May 7, 2021·Internal and Emergency Medicine·Aaron MatlockStephen Yuan-Tung Liang
Jul 31, 2021·Journal of Epidemiology and Community Health·Rodrigo M Carrillo-LarcoAntonio Bernabé-Ortiz

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