Concentrations of ciprofloxacin in the world's rivers are associated with the prevalence of fluoroquinolone resistance in Escherichia coli: a global ecological analysis

Research output: Contribution to journalA1: Web of Science-article


BACKGROUND: Extremely low concentrations of ciprofloxacin may select for antimicrobial resistance. A recent global survey found that ciprofloxacin concentrations exceeded safe levels at 64 sites. In this study, I assessed if national median ciprofloxacin concentrations in rivers were associated with fluoroquinolone resistance in Escherichia coli.

METHODS: Spearman's regression was used to assess the country-level association between the national prevalence of fluoroquinolone resistance in E. coli and the median ciprofloxacin concentration in the country's rivers.

RESULTS: The prevalence of fluoroquinolone resistance in E. coli was positively correlated with the concentration of ciprofloxacin in rivers (ρ = 0.36; p = 0.011; n = 48).

DISCUSSION: Steps to reducing the concentrations of fluoroquinolones in rivers may help prevent the emergence of resistance in E. coli and other bacterial species.

Original languageEnglish
Article number417
Issue number3
Number of pages6
Publication statusPublished - 2022

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