Table 7. Selected co-resistance trends in pathogens isolated from blood and cerebrospinal fluid (CSF) cultures in Pakistan (2011–2015).
| Pathogen | Antimicrobial 1 | Number of isolates resistant to antimicrobial 1 & 2/ Number of isolates resistant to antimicrobial 1 (%) | Number of isolates resistant to antimicrobial 1 & 2/ Number of isolates resistant to antimicrobial 2 (%) | P for difference | Odds ratio 95% CI) | Antimicrobial 2 |
|---|---|---|---|---|---|---|
| Acinetobacter | Cefoperazone-sulbactam | 54/ 54 (100) | 54/ 104 (51.9) | 0.118 | NA | Piperacillin-tazobactam |
| 52/ 54 (96.3) | 52/ 100 (52) | 0.2702 | 3.25 (0.63–16.88) | Amikacin | ||
| 42/ 54 (77.8) | 42/ 79 (53.2) | 0.2777 | 1.61 (0.68–3.8) | Tobramycin | ||
| 53/ 54 (98.1) | 53/ 103 (51.5) | 0.3632 | 4.24 (0.46–39.24) | Gentamicin | ||
| 29/ 54 (53.7) | 29/ 55 (52.7) | 0.5636 | 1.25 (0.59–2.66) | Doxycycline | ||
| 48/ 54 (88.9) | 48/ 96 (50) | 1 | 1 (0.3–3.32) | Trimethoprim-sulphamethoxazole | ||
| Cephalosporin | 79/ 106 (74.5) | 79/ 79 (100) | 0.0703 | NA | Tobramycin | |
| 103/ 106 (97.2) | 103/ 104 (99) | 0.073 | 34.33 (1.71–689.68) | Piperacillin-tazobactam | ||
| 99/ 106 (93.4) | 99/ 100 (99) | 0.1433 | 14.14 (0.8–250.9) | Amikacin | ||
| 55/ 106 (51.9) | 55/ 55 (100) | 0.2385 | NA | Doxycycline | ||
| 54/ 106 (50.9) | 54/ 54 (100) | 0.4953 | NA | Cefoperazone-sulbactam | ||
| Carbapenem | 78/ 104 (75) | 78/ 79 (98.7) | 0.0583 | 9 (0.9–90.33) | Tobramycin | |
| 103/ 104 (99) | 103/ 106 (97.2) | 0.073 | 34.33 (1.71–689.68) | Cephalosporin | ||
| 54/ 104 (51.9) | 54/ 54 (100) | 0.118 | NA | Cefoperazone-sulbactam | ||
| 54/ 104 (51.9) | 54/ 55 (98.2) | 0.3587 | 3.24 (0.33–32.18) | Doxycycline | ||
| Piperacillin-tazobactam | 78/ 104 (75) | 78/ 79 (98.7) | 0.0583 | 9 (0.9–90.33) | Tobramycin | |
| 54/ 104 (51.9) | 54/ 55 (98.2) | 0.3587 | 3.24 (0.33–32.18) | Doxycycline | ||
| Doxycycline | 51/ 55(92.7) | 51/ 96(53.1) | 0.196 | 2.27(0.64–8.03) | Trimethoprim-sulphamethoxazole | |
| Tobramycin | 72/ 79(91.1) | 72/ 96(75) | 0.2984 | 2.14(0.62–7.38) | Trimethoprim-sulphamethoxazole | |
| Escherichia coli | Carbapenem | 3/ 6 (50) | 3/ 133 (2.3) | 0.1118 | 0.25 (0.05–1.32) | Doxycycline |
| 6/ 6 (100) | 6/ 119 (5) | 0.181 | NA | Tobramycin | ||
| 5/ 6 (83.3) | 5/ 96 (5.2) | 0.2367 | 3.96 (0.45–34.62) | Gentamicin | ||
| 6/ 6 (100) | 6/ 137 (4.4) | 0.3604 | NA | 4th generation cephalosporin | ||
| 6/ 6 (100) | 6/ 139 (4.3) | 0.3732 | NA | Trimethoprim-sulphamethoxazole | ||
| 6/ 6 (100) | 6/ 144 (4.2) | 0.5935 | NA | 3rd generation cephalosporin | ||
| 6/ 6 (100) | 6/ 145 (4.1) | 0.5958 | NA | Aztreonam | ||
| 6/ 6 (100) | 6/ 145 (4.1) | 0.5958 | NA | Aztreonam | ||
| 6/ 6 (100) | 6/ 153 (3.9) | 0.6462 | NA | Penicillin | ||
| 6/ 6 (100) | 6/ 153 (3.9) | 0.6462 | NA | Penicillin & β-lactamase inhibitor | ||
| 6/ 6 (100) | 6/ 154 (3.9) | 0.6572 | NA | 2nd generation cephalosporin | ||
| 5/ 6 (83.3) | 5/ 128 (3.9) | 1 | 1.63 (0.18–14.33) | Fluoroquinolone | ||
| Cefoperazone-sulbactam | 12/ 15 (80) | 12/ 96 (12.5) | 0.0575 | 3.33 (0.9–12.28) | Gentamicin | |
| 15/ 15 (100) | 15/ 137 (10.9) | 0.0772 | 1 (17–120) | 4th generation cephalosporin | ||
| 15/ 15 (100) | 15/ 144 (10.4) | 0.1308 | NA | 3rd generation cephalosporin | ||
| 14/ 15 (93.3) | 14/ 139 (10.1) | 0.3139 | 3.25 (0.41–25.7) | Trimethoprim-sulphamethoxazole | ||
| 15/ 15 (100) | 15/ 153 (9.8) | 0.3657 | 1 (17–136) | Penicillin & β-lactamase inhibitor | ||
| 15/ 15 (100) | 15/ 154 (9.7) | 0.3665 | 1 (17–137) | 2nd generation cephalosporin | ||
| 13/ 15 (86.7) | 13/ 128 (10.2) | 0.3665 | 2.2 (0.48–10.2) | Fluoroquinolone | ||
| 14/ 15 (93.3) | 14/ 145 (9.7) | 0.4817 | 2.46 (0.31–19.61) | Aztreonam | ||
| 11/ 15 (73.3) | 11/ 133 (8.3) | 0.7408 | 0.72 (0.22–2.42) | Doxycycline | ||
| Piperacillin-tazobactam | 17/ 17 (100) | 17/ 144 (11.8) | 0.0795 | NA | 3rd generation cephalosporin | |
| 13/ 17 (76.5) | 13/ 96 (13.5) | 0.0843 | 2.7 (0.84–8.66) | Gentamicin | ||
| 17/ 17 (100) | 17/ 145 (11.7) | 0.1351 | 1 (152–1) | Aztreonam | ||
| 16/ 17 (94.1) | 16/ 139 (11.5) | 0.2094 | 3.77 (0.48–29.61) | Trimethoprim-sulphamethoxazole | ||
| 17/ 17 (100) | 17/ 153 (11.1) | 0.2284 | 1 (137–17) | Penicillin & β-lactamase inhibitor | ||
| 17/ 17 (100) | 17/ 154 (11) | 0.2374 | 1 (137–0) | 2nd generation cephalosporin | ||
| 15/ 17 (88.2) | 15/ 128 (11.7) | 0.2494 | 2.59 (0.57–11.83) | Fluoroquinolone | ||
| 14/ 17 (82.4) | 14/ 133 (10.5) | 0.7702 | 1.29 (0.35–4.77) | Doxycycline | ||
| Amikacin | 15/ 22(68.2) | 15/ 133(11.3) | 0.2613 | 0.53 (0.2–1.41) | Doxycycline | |
| 21/ 22(95.5) | 21/ 153(13.7) | 0.4866 | 2.39 (0.3–19.02) | Penicillin & β-lactamase inhibitor | ||
| 21/ 22(95.5) | 21/ 154(13.6) | 0.6957 | 2.21 (0.28–17.7) | 2nd generation cephalosporin | ||
| 16/ 22(72.7) | 16/ 128(12.5) | 0.7238 | 0.83 (0.3–2.29) | Fluoroquinolone | ||
| 17/ 22(77.3) | 17/ 137(12.4) | 0.7703 | 0.77 (0.26–2.25) | 4th generation cephalosporin | ||
| 18/ 22(81.8) | 18/ 139(12.9) | 1 | 0.97 (0.3–3.09) | Trimethoprim-sulphamethoxazole | ||
| 19/ 22(86.4) | 19/ 145(13.1) | 1 | 1.06 (0.29–3.88) | Aztreonam | ||
| 19/ 22(86.4) | 19/ 144(13.2) | 1 | 1.11 (0.3–4.09) | 3rd generation cephalosporin | ||
| Gentamicin | 78/ 96 (81.3) | 78/ 133 (58.6) | 0.3528 | 1.42 (0.68–2.97) | Doxycycline | |
| Salmonella enterica serovar Typhi | Penicillin | 4/5 (80) | 4/ 49 (8.1) | 0.172 | 5.24 (0.567–48.55) | Trimethoprim-sulphamethoxazole |
| 4/5 (80) | 4/ 100 (4) | 0.356 | 0.333 (.033–3.348) | Nalidixic acid | ||
| 4/5 (80) | 4/ 86 (4.65) | 1 | 1.073 (0.114–10.93) | Fluoroquinolone | ||
| Trimethoprim-sulphamethoxazole | 46/49 (93.8) | 46/100 (46) | 0.51 | 1.704 (0.403–7.195) | Nalidixic acid | |
| 39/49 (79.6) | 39/86 (45.3) | 1 | 1.079 (.427–2.727) | Fluoroquinolone | ||
| Staphylococcus aureus | Doxycycline | 7/ 24 (29.2) | 7/ 16 (43.8) | 0.0502 | 2.97 (0.97–9.14) | Amikacin |
| 11/ 24 (45.8) | 11/ 31 (35.5) | 0.0852 | 2.28 (0.88–5.92) | Clindamycin | ||
| 15/ 24 (62.5) | 15/ 48 (31.3) | 0.1273 | 2.07 (0.8–5.33) | Macrolides | ||
| 13/ 24 (54.2) | 13/ 44 (29.5) | 0.2935 | 1.64 (0.65–4.14) | β-lactam (except penicillin) | ||
| 11/ 24 (45.8) | 11/ 37 (29.7) | 0.3475 | 1.56 (0.61–3.98) | Gentamicin | ||
| 12/ 24 (50) | 12/ 47 (25.5) | 0.8179 | 1.11 (0.44–2.8) | Fluoroquinolone | ||
| Trimethoprim-sulphamethoxazole | 25/ 44 (56.8) | 25/ 48 (52.1) | 0.1612 | 1.77 (0.79–3.96) | Macrolides | |
| 8/ 44 (18.2) | 8/ 16 (50) | 0.6538 | 1.28 (0.44–3.74) | Amikacin | ||
| Penicillin | 58/ 95 (61.1) | 58/ 59 (98.3) | 0.5613 | 3.14 (0.27–35.81) | Tobramycin |
Data are number of isolates resistant to both antimicrobials / number of isolates resistant to either antimicrobial 1 (in the case of R1) or antimicrobial 2 (in the case of R1) (%). P-value for difference was calculated using Chi-square test. Odds-ratio was calculated using binary logistic regression and is listed with 95% confidence interval (95% CI). Two-sided p-value has been reported.