Prior trimethoprim use and trimethoprim-resistant urinary tract infection

A nested case-control study with multivariate analysis for other risk factors

Douglas T. Steinke, R. Andrew Seaton, Gabrielle Phillips, Thomas M. MacDonald, Peter G. Davey

    Research output: Contribution to journalArticle

    64 Citations (Scopus)

    Abstract

    Trimethoprim resistance is increasingly prevalent in community-acquired urinary infections. The objective of this study was to evaluate the association between exposure to community-prescribed trimethoprim and other risk factors in subjects and subsequent trimethoprim-resistant urinary tract infection. The design was a nested case-control study using a record-linkage database. Study subjects submitted a urine sample to the Ninewells Hospital Laboratory between July 1993 and December 1995. Antibiotic exposure in subjects with trimethoprim-resistant isolates (cases) was compared with antibiotic exposure in subjects with trimethoprim-susceptible isolates (controls). Study subjects were drawn from the catchment area of a large teaching hospital in Tayside, Scotland. There were 13765 males and females aged 1-106 years who submitted their first urine sample for culture during the study period. After adjustment for significant risk factors and confounding variables, logistic regression analysis showed exposure to trimethoprim [odds ratio (OR) 4.35] or any antibiotic other than trimethoprim (OR 1.32) to be predictive of resistance. The growth of Proteus spp. (OR 115.14) and bacterial growth other than Escherichia coli and Proteus spp. (OR 2.83) were also predictor variables. Hospitalization in the previous 6 months was not independently associated with trimethoprim resistance. In conclusion, trimethoprim resistance was independently associated with exposure to trimethoprim and to antibiotics other than trimethoprim. Reduction in trimethoprim prescribing alone may not reduce the prevalence of trimethoprim resistance.

    Original languageEnglish
    Pages (from-to)781-787
    Number of pages7
    JournalJournal of Antimicrobial Chemotherapy
    Volume47
    Issue number6
    DOIs
    Publication statusPublished - 21 Jun 2001

    Fingerprint

    Trimethoprim
    Urinary Tract Infections
    Case-Control Studies
    Multivariate Analysis
    Trimethoprim Resistance
    Odds Ratio
    Anti-Bacterial Agents
    Proteus
    Urine
    Community-Acquired Infections
    Hospital Laboratories
    Confounding Factors (Epidemiology)
    Scotland
    Growth
    Teaching Hospitals
    Hospitalization
    Logistic Models
    Regression Analysis
    Databases
    Escherichia coli

    Cite this

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    abstract = "Trimethoprim resistance is increasingly prevalent in community-acquired urinary infections. The objective of this study was to evaluate the association between exposure to community-prescribed trimethoprim and other risk factors in subjects and subsequent trimethoprim-resistant urinary tract infection. The design was a nested case-control study using a record-linkage database. Study subjects submitted a urine sample to the Ninewells Hospital Laboratory between July 1993 and December 1995. Antibiotic exposure in subjects with trimethoprim-resistant isolates (cases) was compared with antibiotic exposure in subjects with trimethoprim-susceptible isolates (controls). Study subjects were drawn from the catchment area of a large teaching hospital in Tayside, Scotland. There were 13765 males and females aged 1-106 years who submitted their first urine sample for culture during the study period. After adjustment for significant risk factors and confounding variables, logistic regression analysis showed exposure to trimethoprim [odds ratio (OR) 4.35] or any antibiotic other than trimethoprim (OR 1.32) to be predictive of resistance. The growth of Proteus spp. (OR 115.14) and bacterial growth other than Escherichia coli and Proteus spp. (OR 2.83) were also predictor variables. Hospitalization in the previous 6 months was not independently associated with trimethoprim resistance. In conclusion, trimethoprim resistance was independently associated with exposure to trimethoprim and to antibiotics other than trimethoprim. Reduction in trimethoprim prescribing alone may not reduce the prevalence of trimethoprim resistance.",
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    Prior trimethoprim use and trimethoprim-resistant urinary tract infection : A nested case-control study with multivariate analysis for other risk factors. / Steinke, Douglas T.; Seaton, R. Andrew; Phillips, Gabrielle; MacDonald, Thomas M.; Davey, Peter G.

    In: Journal of Antimicrobial Chemotherapy, Vol. 47, No. 6, 21.06.2001, p. 781-787.

    Research output: Contribution to journalArticle

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    T2 - A nested case-control study with multivariate analysis for other risk factors

    AU - Steinke, Douglas T.

    AU - Seaton, R. Andrew

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