Urban Clusters of E. coli Resistance in Sao Paulo
Author Information
Author(s): Kiffer Carlos RV, Camargo Eduardo CG, Shimakura Silvia E, Ribeiro Paulo J Jr, Bailey Trevor C, Pignatari Antonio CC, Monteiro Antonio MV
Primary Institution: Federal University of São Paulo (UNIFESP)
Hypothesis
Population antimicrobial use may influence resistance emergence.
Conclusion
The study found that E. coli resistance clustering was triggered by ciprofloxacin usage density of 5-9 DDDs per 1,000 inhabitants.
Supporting Evidence
- E. coli CIP resistant cluster emergence was detected and significantly related to usage density.
- The usage density of 5-9 CIP DDDs per 1,000 inhabitants was the resistance triggering level.
- There were clustered hot-spots and significant global spatial variation in resistance risk.
Takeaway
If a lot of people in a city take a certain medicine, it can make some germs stronger and harder to fight.
Methodology
The study used a stochastic model and GIS to analyze E. coli resistance related to ciprofloxacin usage density.
Potential Biases
Potential biases in consumption patterns due to individuals using pharmacies outside their influence zones.
Limitations
The model may not account for all population covariates associated with resistance clustering.
Participant Demographics
Data was collected from female patients aged over 16 years with urinary tract infections.
Statistical Information
P-Value
0.002
Confidence Interval
95%
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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