{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:50:02Z","timestamp":1792788602586,"version":"4.5.0"},"reference-count":24,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2023,5,11]],"date-time":"2023-05-11T00:00:00Z","timestamp":1683763200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/"}],"funder":[{"name":"GSK"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"\n Background<\/jats:title>\n \n Increasing prevalence of antimicrobial resistance (AMR), including multidrug resistance (MDR), among\n Escherichia coli<\/jats:italic>\n (\n E<\/jats:italic>\n .\n coli<\/jats:italic>\n ) makes treatment of uncomplicated urinary tract infection (uUTI) difficult. We assessed risk factors for fluoroquinolone (FQ)-not-susceptible (NS) and MDR\n E<\/jats:italic>\n .\n coli<\/jats:italic>\n among US female outpatients.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n This retrospective cohort study utilized data from female outpatients aged \u2265 12 years with\n E<\/jats:italic>\n .\n coli<\/jats:italic>\n positive urine culture and oral antimicrobial prescription \u00b1 1 day from index. We assessed patient-level factors within 90 and 91\u2013360 days prior to index as predictors of FQ NS (intermediate\/resistant) and MDR (NS to \u2265 1 drug across \u2265 3 classes)\n E<\/jats:italic>\n .\n coli<\/jats:italic>\n : age, prior oral antimicrobial dispensing, prior AMR phenotypes, prior urine culture, and prior hospitalization.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Among 1,858 outpatients with urine-isolated\n E<\/jats:italic>\n .\n coli<\/jats:italic>\n , 369 (19.9%) had FQ NS and 59 (3.2%) had MDR isolates. After multivariable adjustment, independent risk factors (\n p<\/jats:italic>\n < 0.03) for FQ NS\n E<\/jats:italic>\n .\n coli<\/jats:italic>\n were older age, prior FQ NS isolates, prior dispensing of FQ, and dispensing of any oral antibiotic. Independent risk factors (\n p<\/jats:italic>\n < 0.02) for MDR were prior extended-spectrum \u03b2-lactamase-producing isolates (ESBL+), prior FQ dispensing, and prior oral antibiotic dispensing.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n In women with uUTI due to\n E<\/jats:italic>\n .\n coli<\/jats:italic>\n , prior dispensing of FQ or any oral antibiotic within 90 days predicted FQ NS and MDR urine\n E<\/jats:italic>\n .\n coli<\/jats:italic>\n . Prior urine culture with FQ NS isolates and older age were predictive of FQ NS\n E<\/jats:italic>\n .\n coli<\/jats:italic>\n . Prior ESBL+ was predictive of MDR\n E<\/jats:italic>\n .\n coli<\/jats:italic>\n . These data could help identify patients at risk for AMR\n E<\/jats:italic>\n .\n coli<\/jats:italic>\n and inform empiric prescribing.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1371\/journal.pone.0285427","type":"journal-article","created":{"date-parts":[[2023,5,11]],"date-time":"2023-05-11T13:34:32Z","timestamp":1683812072000},"page":"e0285427","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":10,"title":["Older patient age and prior antimicrobial use strongly predict antimicrobial resistance in Escherichia coli isolates recovered from urinary tract infections among female outpatients"],"prefix":"10.1371","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8829-7088","authenticated-orcid":true,"given":"Fanny S.","family":"Mitrani-Gold","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keith S.","family":"Kaye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vikas","family":"Gupta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aruni","family":"Mulgirigama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara W.","family":"Trautner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole E.","family":"Scangarella-Oman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kalvin C.","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gang","family":"Ye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashish V.","family":"Joshi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2023,5,11]]},"reference":[{"key":"pone.0285427.ref001","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":"M Medina","year":"2019","journal-title":"Ther Adv Urol"},{"issue":"1","key":"pone.0285427.ref002","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":"B. 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