{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T22:55:43Z","timestamp":1793228143890,"version":"4.5.0"},"reference-count":38,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2021,6,18]],"date-time":"2021-06-18T00:00:00Z","timestamp":1623974400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004330","name":"GlaxoSmithKline plc","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100004330","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Fraser Shearer, Ashfield MedComms, an Ashfield Health"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,12,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Uncomplicated urinary tract infection (uUTI) is predominantly caused by Escherichia coli, which has increasing antimicrobial resistance (AMR) at the United States (US)-community level. As uUTI is often treated empirically, assessing AMR is challenging, and there are limited contemporary data characterizing period prevalence in the US.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This was a retrospective study of AMR using Becton, Dickinson and Company Insights Research Database (Franklin Lakes, New Jersey, US) data collected 2011\u20132019. Thirty-day, nonduplicate Escherichia coli urine isolates from US female outpatients (aged\u2005\u226512 years) were included. Isolates were evaluated for nonsusceptibility (intermediate\/resistant) to trimethoprim-sulfamethoxazole, fluoroquinolones, or nitrofurantoin, and assessed for extended-spectrum \u03b2-lactamase production (ESBL+) and for \u22652 or \u22653 drug-resistance phenotypes. Generalized estimating equations were used to model AMR trends over time and by US census region.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among 1 513 882 E. coli isolates, the overall prevalence of isolates nonsusceptible to trimethoprim-sulfamethoxazole, fluoroquinolones, and nitrofurantoin was 25.4%, 21.1%, and 3.8%, respectively. Among the isolates, 6.4% were ESBL+, 14.4% had \u22652 drug-resistance phenotypes, and 3.8% had \u22653. Modeling demonstrated a relative average yearly increase of 7.7% (95% confidence interval [CI], 7.2\u20138.2%) for ESBL+ isolates and 2.7% (95% CI, 2.2\u20133.2%) for \u22653 drug-phenotypes (both P\u2005&amp;lt;\u2005.0001). Modeling also demonstrated significant variation in AMR prevalence between US census regions (P\u2005&amp;lt;\u2005.001).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Period prevalence of AMR among US outpatient urine-isolated E. coli was high, and for multidrug-resistance phenotypes increased during the study period with significant variation between census regions. Knowledge of regional AMR rates helps inform empiric treatment of community-onset uUTI and highlights the AMR burden to physicians.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciab560","type":"journal-article","created":{"date-parts":[[2021,6,18]],"date-time":"2021-06-18T17:18:20Z","timestamp":1624036700000},"page":"1992-1999","source":"Crossref","is-referenced-by-count":130,"title":["Antimicrobial Resistance Trends in Urine <i>Escherichia coli<\/i> Isolates From Adult and Adolescent Females in the United States From 2011 to 2019: Rising ESBL Strains and Impact on Patient Management"],"prefix":"10.1093","volume":"73","author":[{"given":"Keith S","family":"Kaye","sequence":"first","affiliation":[{"name":"University of Michigan, Ann Arbor, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vikas","family":"Gupta","sequence":"additional","affiliation":[{"name":"Becton, Dickinson and Company (BD), Franklin Lakes, New Jersey, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aruni","family":"Mulgirigama","sequence":"additional","affiliation":[{"name":"GlaxoSmithKline plc., London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashish V","family":"Joshi","sequence":"additional","affiliation":[{"name":"GlaxoSmithKline plc., Collegeville, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole E","family":"Scangarella-Oman","sequence":"additional","affiliation":[{"name":"GlaxoSmithKline plc., Collegeville, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kalvin","family":"Yu","sequence":"additional","affiliation":[{"name":"Becton, Dickinson and Company (BD), Franklin Lakes, New Jersey, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gang","family":"Ye","sequence":"additional","affiliation":[{"name":"Becton, Dickinson and Company (BD), Franklin Lakes, New Jersey, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fanny S","family":"Mitrani-Gold","sequence":"additional","affiliation":[{"name":"GlaxoSmithKline plc., Collegeville, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,6,18]]},"reference":[{"key":"2021121022471031400_CIT0001","doi-asserted-by":"crossref","first-page":"1756287219832172","DOI":"10.1177\/1756287219832172","article-title":"An introduction to the epidemiology and burden of urinary tract infections","volume":"11","author":"Medina","year":"2019","journal-title":"Ther Adv Urol"},{"key":"2021121022471031400_CIT0002","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.idc.2013.09.003","article-title":"Urinary tract infection syndromes: occurrence, recurrence, bacteriology, risk factors, and disease burden","volume":"28","author":"Foxman","year":"2014","journal-title":"Infect Dis Clin North 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