Repurposing antibiotic resistance surveillance data to support treatment of recurrent infections in a remote setting
Abstract In northern Australia, a region with limited access to healthcare and a substantial population living remotely, antibiotic resistance adds to the complexity of treating infections. Focussing on Escherichia coli urinary tract infections (UTIs) and Staphylococcus aureus skin & soft tissue...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2024-01-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-023-50008-4 |
| _version_ | 1797274908749725696 |
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| author | Will Cuningham Shalinie Perera Sonali Coulter Zhiqiang Wang Steven Y. C. Tong Teresa M. Wozniak |
| author_facet | Will Cuningham Shalinie Perera Sonali Coulter Zhiqiang Wang Steven Y. C. Tong Teresa M. Wozniak |
| author_sort | Will Cuningham |
| collection | DOAJ |
| description | Abstract In northern Australia, a region with limited access to healthcare and a substantial population living remotely, antibiotic resistance adds to the complexity of treating infections. Focussing on Escherichia coli urinary tract infections (UTIs) and Staphylococcus aureus skin & soft tissue infections (SSTIs) captured by a northern Australian antibiotic resistance surveillance system, we used logistic regression to investigate predictors of a subsequent resistant isolate during the same infection episode. We also investigated predictors of recurrent infection. Our analysis included 98,651 E. coli isolates and 121,755 S. aureus isolates from 70,851 patients between January 2007 and June 2020. Following an initially susceptible E. coli UTI, subsequent recovery of a cefazolin (8%) or ampicillin (13%) -resistant isolate during the same infection episode was more common than a ceftriaxone-resistant isolate (2%). For an initially susceptible S. aureus SSTI, subsequent recovery of a methicillin-resistant isolate (8%) was more common than a trimethoprim-sulfamethoxazole-resistant isolate (2%). For UTIs and SSTIs, prior infection with a resistant pathogen was a strong predictor of both recurrent infection and resistance in future infection episodes. This multi-centre study demonstrates an association between antibiotic resistance and an increased likelihood of recurrent infection. Particularly in remote areas, a patient’s past antibiograms should guide current treatment choices since recurrent infection will most likely be at least as resistant as previous infection episodes. Using population-level surveillance data in this way can also help clinicians decide if they should switch antibiotics for patients with ongoing symptoms, while waiting for diagnostic results. |
| first_indexed | 2024-03-07T15:06:50Z |
| format | Article |
| id | doaj.art-086ebf3a24e7415684e4048c2d89f9a5 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-03-07T15:06:50Z |
| publishDate | 2024-01-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-086ebf3a24e7415684e4048c2d89f9a52024-03-05T18:52:11ZengNature PortfolioScientific Reports2045-23222024-01-0114111310.1038/s41598-023-50008-4Repurposing antibiotic resistance surveillance data to support treatment of recurrent infections in a remote settingWill Cuningham0Shalinie Perera1Sonali Coulter2Zhiqiang Wang3Steven Y. C. Tong4Teresa M. Wozniak5Menzies School of Health Research, Charles Darwin UniversityWestern Diagnostic PathologyMedication Services Queensland, Prevention Division, Department of HealthMenzies School of Health Research, Charles Darwin UniversityMenzies School of Health Research, Charles Darwin UniversityMenzies School of Health Research, Charles Darwin UniversityAbstract In northern Australia, a region with limited access to healthcare and a substantial population living remotely, antibiotic resistance adds to the complexity of treating infections. Focussing on Escherichia coli urinary tract infections (UTIs) and Staphylococcus aureus skin & soft tissue infections (SSTIs) captured by a northern Australian antibiotic resistance surveillance system, we used logistic regression to investigate predictors of a subsequent resistant isolate during the same infection episode. We also investigated predictors of recurrent infection. Our analysis included 98,651 E. coli isolates and 121,755 S. aureus isolates from 70,851 patients between January 2007 and June 2020. Following an initially susceptible E. coli UTI, subsequent recovery of a cefazolin (8%) or ampicillin (13%) -resistant isolate during the same infection episode was more common than a ceftriaxone-resistant isolate (2%). For an initially susceptible S. aureus SSTI, subsequent recovery of a methicillin-resistant isolate (8%) was more common than a trimethoprim-sulfamethoxazole-resistant isolate (2%). For UTIs and SSTIs, prior infection with a resistant pathogen was a strong predictor of both recurrent infection and resistance in future infection episodes. This multi-centre study demonstrates an association between antibiotic resistance and an increased likelihood of recurrent infection. Particularly in remote areas, a patient’s past antibiograms should guide current treatment choices since recurrent infection will most likely be at least as resistant as previous infection episodes. Using population-level surveillance data in this way can also help clinicians decide if they should switch antibiotics for patients with ongoing symptoms, while waiting for diagnostic results.https://doi.org/10.1038/s41598-023-50008-4 |
| spellingShingle | Will Cuningham Shalinie Perera Sonali Coulter Zhiqiang Wang Steven Y. C. Tong Teresa M. Wozniak Repurposing antibiotic resistance surveillance data to support treatment of recurrent infections in a remote setting Scientific Reports |
| title | Repurposing antibiotic resistance surveillance data to support treatment of recurrent infections in a remote setting |
| title_full | Repurposing antibiotic resistance surveillance data to support treatment of recurrent infections in a remote setting |
| title_fullStr | Repurposing antibiotic resistance surveillance data to support treatment of recurrent infections in a remote setting |
| title_full_unstemmed | Repurposing antibiotic resistance surveillance data to support treatment of recurrent infections in a remote setting |
| title_short | Repurposing antibiotic resistance surveillance data to support treatment of recurrent infections in a remote setting |
| title_sort | repurposing antibiotic resistance surveillance data to support treatment of recurrent infections in a remote setting |
| url | https://doi.org/10.1038/s41598-023-50008-4 |
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