Background Antimicrobial resistance to quinolone is rising worldwide, especially in Escherichia coli causing various infections. Although many studies have been conducted to identify the risk factors for quinolone-resistant Escherichia coli (QREC) infection, the results are inconsistent and have not been systematically reported. The aim of the present study is to conduct a systematic review and meta-analysis to evaluate the potential risk factors for QREC infection. Methods A systematic search was performed to collect published data in the EMBASE, PubMed, and the Cochrane Library up to April 2019. Risk factors were analyzed using the pooled odds ratio (ORs) with 95% confidence interval (CIs). Results Twenty-seven trials involving 67,019 participants were included in the present study. The following risk factors associated with QREC infection were identified: (1) male (OR = 1.41), (2) hepatic cirrhosis (OR = 2.05), (3) diabetes mellitus (OR = 1.62), (4) cardiovascular disease (OR = 1.76), (5) neurogenic bladder (OR = 8.66), (6) renal dysfunction (OR = 2.47), (7) transplantation (OR = 2.37), (8) urinary tract infection (OR = 2.79) and urinary tract abnormality (OR = 1.85), (9) dementia (OR = 5.83), (10) heart failure (OR = 5.63), (11) neurologic disease (OR = 2.80), (12) immunosuppressive drugs (OR = 2.02), (13) urinary catheter (OR = 4.39), (14) nursing home resident (OR = 4.63), (15) prior surgery (OR = 2.54), (16) quinolones (OR = 7.67), (17) other antibiotics (OR = 2.74), (18) hospitalization (OR = 2.06) and (19) nosocomial infection acquisition (OR = 2.35). Conclusions QREC infection was associated with nineteen risk factors including prior quinolones use, hospitalization, and several comorbidities. Reducing exposure to these risk factors and modification of antibiotic use are important to prevent quinolone resistance.

中文翻译：

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喹诺酮耐药性大肠杆菌感染的危险因素：系统评价和荟萃分析。

背景技术全世界范围内，尤其是在引起各种感染的大肠杆菌中，对喹诺酮类药物的耐药性正在上升。尽管已经进行了许多研究来确定对喹诺酮耐药的大肠杆菌（QREC）感染的危险因素，但结果不一致，尚未系统报道。本研究的目的是进行系统的审查和荟萃分析，以评估QREC感染的潜在危险因素。方法进行了系统的搜索，以收集截至2019年4月在EMBASE，PubMed和Cochrane图书馆中发布的数据。使用汇总比值比（OR）和95％置信区间（CI）来分析风险因素。结果本研究共纳入27个试验，涉及67,019名参与者。结论QREC感染与19种危险因素有关，包括以前使用喹诺酮，住院和其他多种合并症。减少这些危险因素的暴露和改变抗生素的使用对预防喹诺酮耐药性很重要。