2026-10-13T08:00:54Z https://api.figshare.com/v2/oai

oai:figshare.com:article/34007871 2026-09-28T04:23:06Z category_303 portal_316 item_type_3 month_year_09_2026

Table 1_Class-matched antibiotic dispensing and susceptibility transitions in recurrent urinary gram-negative bacilli.docx Ibrahim Tawhari (14277209) Mona M. Alshahrani (24776770) Mohammed Alshehri (6718820) Ali M. Somily (5548091) Khalifa Binkhamis (14222927) Abdulah J. Alqahtani (21955367) Abdullah A. Al-Shahrani (25119141) Safia Abdullah Mohammed (24677161) Esmahan Tahtouh (24677167) Mohammed Tawhari (24557538) Yahya Shabi (23091619) Abdulah O. S. Bawazeer (24422447) Clinical Microbiology antibiotic exposure antimicrobial resistance antimicrobial stewardship difficult-to-treat resistance gram-negative bacilli urinary tract Objectives<p>Antimicrobial resistance (AMR) among urinary Gram-negative bacilli (GNB) is rising in Saudi Arabia, but how interim antibiotic exposure relates to within-patient changes in susceptibility is not well characterized. We evaluated the association between class-matched antibiotic exposure occurring between consecutive cultures and susceptible (S)-to-non-susceptible (NS) and non-susceptible-to-susceptible transitions.</p>Methods<p>In a single-center, retrospective, culture-based, pharmacy-linked paired-culture cohort at a 500-bed tertiary hospital in southern Saudi Arabia (Aseer Central Hospital [ACH]), consecutive same-patient, same-species urinary GNB cultures 14–365 days apart formed pairs, and interim exposure was defined as ACH-recorded antibiotic dispensing. For each of the seven feasible phenotypes, adjusted transition models estimated S→NS odds and separate direct models estimated NS→S odds, with supporting analyses using inverse probability weighting, cross-class models, E-values, penalized-likelihood sensitivity analyses, and exploratory pragmatic null-covariable diagnostics.</p>Results<p>The primary cohort comprised 1,274 pairs from 1,078 patients, of whom 807 (74.9%) had at least one interim ACH-recorded systemic antibiotic dispensing. Class-matched dispensing was associated with higher adjusted odds of an S→NS transition for extended-spectrum cephalosporins (OR, 3.83), difficult-to-treat resistance (OR, 2.91), piperacillin–tazobactam (OR, 2.46), and fluoroquinolones (OR, 2.29), but not carbapenems (OR, 0.93). In direct models, matched dispensing was associated with lower odds of an NS→S transition, reaching significance only for piperacillin–tazobactam (OR, 0.39).</p>Conclusions<p>In recurrent urinary GNB, interim class-matched hospital-recorded antibiotic dispensing was associated with within-patient S→NS transitions for several clinically important phenotypes. These observational associations do not establish treatment effects; they identify patterns for confirmation in prospective studies and may inform surveillance and stewardship evaluation.</p> 2026-09-28T04:23:06Z Dataset Dataset 10.3389/fcimb.2026.1897524.s001 https://figshare.com/articles/dataset/Table_1_Class-matched_antibiotic_dispensing_and_susceptibility_transitions_in_recurrent_urinary_gram-negative_bacilli_docx/34007871 CC BY 4.0