Fluoroquinolone (FQ) utilization in symptomatic bacteriuria (SB) due to E. coli and rate of FQ-resistant E. coli in a teaching psychiatric hospital

Results Overall, 146 SB and 176 organisms were recorded in LTC wards vs. 336 and 376 in AGP wards, respectively. E. coli accounted for 55 % of urinary isolates in LTC wards vs. 68% in AGP wards (p<0.01). In AGP wards, there was no significant trend (c2) in the year-to-year utilization of FQ for treating SB (range 60%>75%) as well as in the rate of FQ-resistant E. coli, rising from 12% to 15% over the study period. In contrast, a significant increase in the rate of FQ-resistant E. coli causing SB (from 11% to 50%, p<0.01) was seen in LTC wards over the study period and was concomitant of a linear decrease (r=0.90, p<0.05) in FQ utilization for treating SB in this setting. This increasing resistance rate could be explained in part by the high level of FQ utilization (74%) for treating SB in the LTC wards during the first year of the survey; yet other factors might be involved. Conclusion In this study, rate of FQ-resistant E. coli appeared relatively low in the AGP wards despite the extensive use of FQ. However, enhanced surveillance in LTC geriatric wards seems required because of the risk of emerging high rate of FQ-resistant E. coli in this setting.