Methods: Adults with cUTI at Palmetto Health Hospitals in Columbia, SC from April 1 to July 31, 2015 were prospectively identified. Multivariate logistic regression was used to examine association between prior fluoroquinolone use within 12 months of cUTI and fluoroquinolone resistance. Areas under receiver operating characteristic curves (AUC) were calculated to determine discrimination of FQRS models, using prior fluoroquinolone exposure up to 6 and 12 months, respectively.
Results: Among 238 unique patients with cUTI, 54 (23%) had fluoroquinolone-resistant urinary isolates. Overall, median age was 66 years, 87 (37%) were men and Escherichia coli (137; 58%) was the most common isolate. Prior fluoroquinolone use within 3 months (odds ratio [OR] 30.3, 95% confidence intervals [CI] 10.5-101.0, p<0.001) and within 3-12 months (OR 19.2, 95% CI 6.9-58.4, p<0.001) was independently associated with increased risk of cUTI due to fluoroquinolone-resistant isolates compared to no prior exposure (referent). AUC increased from 0.73 to 0.80 when prior fluoroquinolone use was extended from 6 to 12 months in FQRS. Patients with FQRS of 0, 2, 3 and 5 had estimated risk of fluoroquinolone-resistant urinary isolates of 6%, 19%, 31% and 60%, respectively.
P. B. Bookstaver, Allergan Pharmaceuticals: Scientific Advisor , Research grant
J. Kohn, None
H. Albrecht, None
M. Al-Hasan, None
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