Unknown

Dataset Information

0

Resistance in Enterobacterales Is Higher Among People Living With Human Immunodeficiency Virus.


ABSTRACT:

Background

Multidrug-resistant Enterobacterales (MDR-E) are important pathogens. People living with human immunodeficiency virus (HIV; PLWH) may be at greater risk for MDR-E infection given relatively high antibiotic exposure and burden of comorbidities.

Methods

We analyzed data from 36 521 patients in a healthcare system in North Carolina who had a clinical culture with growth of an Enterobacterales species from 2000 to 2018; 440 were PLWH. We used generalized linear models to estimate prevalence ratios and differences, contrasting PLWH and people not living with HIV (PNLWH) for resistance to individual antibiotic classes, as well as MDR-E. We assessed trends in prevalence over time by calculating the 5-year moving average and fitting restricted cubic spline models.

Results

The overall prevalence of MDR-E was higher among PLWH (21.5%; 95% confidence interval [CI], 18.2%-25.1%) vs PNLWH (16.5%; 95% CI, 16.2%-16.9%), with an adjusted prevalence ratio of 1.38 (95% CI, 1.14-1.65). PLWH had higher rates of antimicrobial resistance than PNLWH for all antibiotic classes analyzed, including penicillins, penicillin/beta lactamase inhibitor combinations, and sulfonamides. MDR-E prevalence was 3 to 10 percentage points higher among PLWH than PNLWH throughout the study period based on the 5-year moving average.

Conclusions

In a large clinical study population in the southeastern United States from 2000 to 2018, the prevalence of antibacterial resistance among Enterobacterales was consistently higher among PLWH than PNLWH. These data highlight the importance of identifying and mitigating the factors that contribute to antimicrobial resistance in PLWH, given the potential clinical consequences of these resistant pathogens.

SUBMITTER: Henderson HI 

PROVIDER: S-EPMC9402620 | biostudies-literature | 2022 Aug

REPOSITORIES: biostudies-literature

altmetric image

Publications

Resistance in Enterobacterales Is Higher Among People Living With Human Immunodeficiency Virus.

Henderson Heather I HI   Napravnik Sonia S   Gower Emily W EW   Aiello Allison E AE   Kinlaw Alan C AC   Williams Billy B   Wohl David A DA   van Duin David D  

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 20220801 1


<h4>Background</h4>Multidrug-resistant Enterobacterales (MDR-E) are important pathogens. People living with human immunodeficiency virus (HIV; PLWH) may be at greater risk for MDR-E infection given relatively high antibiotic exposure and burden of comorbidities.<h4>Methods</h4>We analyzed data from 36 521 patients in a healthcare system in North Carolina who had a clinical culture with growth of an Enterobacterales species from 2000 to 2018; 440 were PLWH. We used generalized linear models to es  ...[more]

Similar Datasets

| S-EPMC10230783 | biostudies-literature
| S-EPMC11209141 | biostudies-literature
| S-EPMC5652316 | biostudies-literature
| S-EPMC11197211 | biostudies-literature
| S-EPMC6579953 | biostudies-literature
| S-EPMC7211976 | biostudies-literature
| S-EPMC6389504 | biostudies-literature
| S-EPMC8326558 | biostudies-literature
| S-EPMC8016250 | biostudies-literature
| S-EPMC11487059 | biostudies-literature