Antibiotic prescriptions and risk factors for antimicrobial resistance in patients hospitalized with urinary tract infection: a matched case-control study using the French health insurance database (SNDS)
Abstract Background Antibiotic resistance is increasing among urinary pathogens, resulting in worse clinical and economic outcomes. We analysed factors associated with antibiotic-resistant bacteria (ARB) in patients hospitalized for urinary tract infection, using the comprehensive French national cl...
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doaj-addc63f98cca4f1e84a14d0900f7b4822021-06-20T11:08:00ZengBMCBMC Infectious Diseases1471-23342021-06-0121111210.1186/s12879-021-06287-1Antibiotic prescriptions and risk factors for antimicrobial resistance in patients hospitalized with urinary tract infection: a matched case-control study using the French health insurance database (SNDS)Marion Opatowski0Christian Brun-Buisson1Mehdi Touat2Jérôme Salomon3Didier Guillemot4Philippe Tuppin5Laurence Watier6Epidemiology and Modeling of bacterial Evasion to Antibacterials Unit (EMEA), Institut PasteurEpidemiology and Modeling of bacterial Evasion to Antibacterials Unit (EMEA), Institut PasteurEpidemiology and Modeling of bacterial Evasion to Antibacterials Unit (EMEA), Institut PasteurEpidemiology and Modeling of bacterial Evasion to Antibacterials Unit (EMEA), Institut PasteurEpidemiology and Modeling of bacterial Evasion to Antibacterials Unit (EMEA), Institut PasteurFrench National Health Insurance (Cnam)Epidemiology and Modeling of bacterial Evasion to Antibacterials Unit (EMEA), Institut PasteurAbstract Background Antibiotic resistance is increasing among urinary pathogens, resulting in worse clinical and economic outcomes. We analysed factors associated with antibiotic-resistant bacteria (ARB) in patients hospitalized for urinary tract infection, using the comprehensive French national claims database. Methods Hospitalized urinary tract infections were identified from 2015 to 2017. Cases (due to ARB) were matched to controls (without ARB) according to year, age, sex, infection, and bacterium. Healthcare-associated (HCAI) and community-acquired (CAI) infections were analysed separately; logistic regressions were stratified by sex. Results From 9460 cases identified, 6468 CAIs and 2855 HCAIs were matched with controls. Over a 12-months window, the risk increased when exposure occurred within the last 3 months. The following risk factors were identified: antibiotic exposure, with an OR reaching 3.6 [2.8–4.5] for men with CAI, mostly associated with broad-spectrum antibiotics; surgical procedure on urinary tract (OR 2.0 [1.5–2.6] for women with HCAI and 1.3 [1.1–1.6] for men with CAI); stay in intensive care unit > 7 days (OR 1.7 [1.2–2.6] for men with HCAI). Studied co-morbidities had no impact on ARB. Conclusions This study points out the critical window of 3 months for antibiotic exposure, confirms the impact of broad-spectrum antibiotic consumption on ARB, and supports the importance of prevention during urological procedures, and long intensive care unit stays.https://doi.org/10.1186/s12879-021-06287-1Antimicrobial resistanceUrinary tract infectionsSNDSMedico-administrative databaseAdministrative claims databaseRisk factors, antibiotic consumption |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Marion Opatowski Christian Brun-Buisson Mehdi Touat Jérôme Salomon Didier Guillemot Philippe Tuppin Laurence Watier |
spellingShingle |
Marion Opatowski Christian Brun-Buisson Mehdi Touat Jérôme Salomon Didier Guillemot Philippe Tuppin Laurence Watier Antibiotic prescriptions and risk factors for antimicrobial resistance in patients hospitalized with urinary tract infection: a matched case-control study using the French health insurance database (SNDS) BMC Infectious Diseases Antimicrobial resistance Urinary tract infections SNDS Medico-administrative database Administrative claims database Risk factors, antibiotic consumption |
author_facet |
Marion Opatowski Christian Brun-Buisson Mehdi Touat Jérôme Salomon Didier Guillemot Philippe Tuppin Laurence Watier |
author_sort |
Marion Opatowski |
title |
Antibiotic prescriptions and risk factors for antimicrobial resistance in patients hospitalized with urinary tract infection: a matched case-control study using the French health insurance database (SNDS) |
title_short |
Antibiotic prescriptions and risk factors for antimicrobial resistance in patients hospitalized with urinary tract infection: a matched case-control study using the French health insurance database (SNDS) |
title_full |
Antibiotic prescriptions and risk factors for antimicrobial resistance in patients hospitalized with urinary tract infection: a matched case-control study using the French health insurance database (SNDS) |
title_fullStr |
Antibiotic prescriptions and risk factors for antimicrobial resistance in patients hospitalized with urinary tract infection: a matched case-control study using the French health insurance database (SNDS) |
title_full_unstemmed |
Antibiotic prescriptions and risk factors for antimicrobial resistance in patients hospitalized with urinary tract infection: a matched case-control study using the French health insurance database (SNDS) |
title_sort |
antibiotic prescriptions and risk factors for antimicrobial resistance in patients hospitalized with urinary tract infection: a matched case-control study using the french health insurance database (snds) |
publisher |
BMC |
series |
BMC Infectious Diseases |
issn |
1471-2334 |
publishDate |
2021-06-01 |
description |
Abstract Background Antibiotic resistance is increasing among urinary pathogens, resulting in worse clinical and economic outcomes. We analysed factors associated with antibiotic-resistant bacteria (ARB) in patients hospitalized for urinary tract infection, using the comprehensive French national claims database. Methods Hospitalized urinary tract infections were identified from 2015 to 2017. Cases (due to ARB) were matched to controls (without ARB) according to year, age, sex, infection, and bacterium. Healthcare-associated (HCAI) and community-acquired (CAI) infections were analysed separately; logistic regressions were stratified by sex. Results From 9460 cases identified, 6468 CAIs and 2855 HCAIs were matched with controls. Over a 12-months window, the risk increased when exposure occurred within the last 3 months. The following risk factors were identified: antibiotic exposure, with an OR reaching 3.6 [2.8–4.5] for men with CAI, mostly associated with broad-spectrum antibiotics; surgical procedure on urinary tract (OR 2.0 [1.5–2.6] for women with HCAI and 1.3 [1.1–1.6] for men with CAI); stay in intensive care unit > 7 days (OR 1.7 [1.2–2.6] for men with HCAI). Studied co-morbidities had no impact on ARB. Conclusions This study points out the critical window of 3 months for antibiotic exposure, confirms the impact of broad-spectrum antibiotic consumption on ARB, and supports the importance of prevention during urological procedures, and long intensive care unit stays. |
topic |
Antimicrobial resistance Urinary tract infections SNDS Medico-administrative database Administrative claims database Risk factors, antibiotic consumption |
url |
https://doi.org/10.1186/s12879-021-06287-1 |
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