scholarly journals Antibiotic resistance in isolates recovered from women with community-acquired urinary tract infections presenting to a tertiary care emergency department

CJEM ◽  
2012 ◽  
Vol 14 (05) ◽  
pp. 295-305 ◽  
Author(s):  
Lyne Filiatrault ◽  
Rachel M. McKay ◽  
David M. Patrick ◽  
Diane L. Roscoe ◽  
Grahame Quan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Antibiotic Resistance ◽  
Risk Factor ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Tertiary Care ◽  
Antibiotic Use ◽  
Adult Females ◽  
Tract Infections

ABSTRACTIntroduction:We sought to determine the antibiotic susceptibility of organisms causing community-acquired urinary tract infections (UTIs) in adult females attending an urban emergency department (ED) and to identify risk factors for antibiotic resistance.Methods:We reviewed the ED charts of all nonpregnant, nonlactating adult females with positive urine cultures for 2008 and recorded demographics, diagnosis, complicating factors, organism susceptibility, and risk factors for antibiotic resistance. Odds ratios (ORs) and 95% confidence intervals (CIs) for potential risk factors were calculated.Results:Our final sample comprised 327 UTIs: 218 were cystitis, of which 22 were complicated cases and 109 were pyelonephritis, including 22 complicated cases.Escherichia coliaccounted for 82.3% of all UTIs, whereasStaphylococcus saprophyticusaccounted for 5.2%. In uncomplicated cystitis, 9.5% of all isolates were resistant to ciprofloxacin and 24.0% to trimethoprim-sulfamethoxazole (TMP-SMX). In uncomplicated pyelonephritis, 19.5% of isolates were resistant to ciprofloxacin and 36.8% to TMP-SMX. In UTI (all types combined), any antibiotic use within the previous 3 months was a significant risk factor for resistance to both ciprofloxacin (OR 3.34, 95% CI 1.16–9.62) and TMP-SMX (OR 4.02, 95% CI 1.48–10.92). Being 65 years of age or older and having had a history of UTI in the previous year were risk factors only for ciprofloxacin resistance.Conclusions:E. coliwas the predominant urinary pathogen in this series. Resistance to ciprofloxacin and TMP-SMX was high, highlighting the importance of relevant, local antibiograms. Any recent antibiotic use was a risk factor for both ciprofloxacin and TMP-SMX resistance in UTI. Our findings should be confirmed with a larger prospective study.

678 Urinary tract infections requiring hospitalization: Risk factors, microbiological characteristics and patterns of antibiotic resistance

2014 ◽  
Vol 13 (1) ◽  
pp. e678
Author(s):  
J. Medina-Polo ◽  
S. Pérez-Cadavid ◽  
A. Arrébola-Pajares ◽  
R. Sopeña-Sutil ◽  
R. Benítez-Salas ◽  
...  
Keyword(s):  
Risk Factors ◽  
Antibiotic Resistance ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Microbiological Characteristics ◽  
Tract Infections

scholarly journals A study of risk factors for bacteremia caused by urinary tract infections

2018 ◽  
Vol 9 (5) ◽  
pp. 25-30
Author(s):  
Muralidhar Varma ◽  
Sravan Kumar Peravali ◽  
Vandana KE ◽  
Asha Kamath ◽  
Rahul Singh
Keyword(s):  
Risk Factors ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Urine Culture ◽  
Tertiary Care ◽  
Blood Cultures ◽  
Medical Sciences ◽  
E Coli ◽  
Tract Infections ◽  
Control Study

Background: Urinary tract infections are not only one of the most common infections, but also one of the most common sources of bacteremia in both the general population and hospitalized patients.Aims and Objectives: The objective of this study was to identify risk factors for bacteremia caused by urinary tract infections.Materials and Methods: This was a prospective case control study conducted from October 2012 to July 2014in a tertiary care teaching hospital in southern India. Urinary tract infections were diagnosed based on the CDC criteria.Patients witha set of blood cultures and urine culture isolating same organism were grouped as cases while patients with urine culture alone isolating organism with sterile blood cultures were identified as controls.Results: Out of the 198 patientsin the study, 66 were cases while 132 were controls. E coli was the most organism isolated (81% of cases and 66% of controls). Risk factors for bacteremia based on univariate and multivariate analysis were diabetes mellitus with uncontrolled sugars (univariate: p=0.001; OR=5.250 [2.044-13.582]; and multivariate: p=0.01; OR= 6.023 [1.52-23.51]) and pyelonephritis (univariate: p=0.001; OR=6.56 [2.87-1.48]; and multivariate: p=0.047; OR=4.95 [1.02-24.12]).Conclusion: Upper UTI and complicated UTI patients should be evaluated for bacteremia since prompt and targeted treatment may be required.Asian Journal of Medical Sciences Vol.9(5) 2018 25-30

scholarly journals Etiological  characteristic  and risk factors of ESBL-Urinary Tract Infections: A nomogram had been built and Urologist should act in time

2020 ◽  
Author(s):  
Yi Wei ◽  
Chengjun Yu ◽  
Tianxing Zhao ◽  
Tao Lin ◽  
Dawei He ◽  
...  
Keyword(s):  
Risk Factors ◽  
Antibiotic Resistance ◽  
Urinary Tract ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Antibiotic Use ◽  
Clinical Microbiology Laboratory ◽  
Neurologic Disorder ◽  
Extended Spectrum Beta Lactamase ◽  
Tract Infections

Abstract Background: The presence of urinary tract infection (UTI) due to Extended-Spectrum Beta-Lactamase (ESBL)-producing bacteria is reported increased. Aim to study the most frequent uropathogens and the antibiotic susceptibility patterns of them in children and identify whether urodynamic change, underlying neurologic disorders and undernourishment were independent risk factors for ESBL positive UTI which is unclear. Methods: We retrospectively reviewed microbial etiologies and antimicrobial resistance among patients experiencing UTI events in the urology ward of Chongqing Medical University Afflicated Chlidren's Hospital from January 1994 and December 2019. All strains were cultured and identified by the Clinical Microbiology Laboratory. Results: A total of 854 patients with UTI over a 26-years period were evaluated and Escherichia coli was the most common pathogen. During the study period, the proportion of UTI cases attributed to Enterococci increased significantly. Susceptibilities to carbapenems and amikacin decreased significantly, indicating increased antibiotic resistance of pathogens associated with UTI. Interestingly, the susceptibilities to piperacillin/tazobactam have increased. 72.64% were caused by ESBL bacteria and ESBL-producing bacteria increased significantly. ESBL (+) and ESBL (-) UTI were compared and there were no significant differences in the clinical presentation between gender, side of the lesion and urodynamic results. Significant potential risk factors of ESBL-UTI were presence of congenital urological abnormalities, vesicoureteral reflux, neurologic disorder, age <12months, fever and previous use of antibiotics in the last 3 months. On logistic regression analysis, underlying neurologic disorder (OR =8, CI 1.845-34.695) and history of previous antibiotics administration in the last 3 months (OR =4.764, CI 3.114-7.289) were identified as an independent significant risk factor for ESBL- UTI. The nomogram generated was well calibrated for all predictions of ESBL+ probability, and the accuracy of the model nomogram measured by Harrell’s C statistic (C-index) was 0.741. Conclusions: The current situation of multiple bacterial antibiotic resistance has become a worrisome issue in UTI, and urologist should act timely. Our data will greatly assist physicians recognizing the risk factors of ESBL-UTI and optimising antibiotic use.

Antibiotic resistance in E. coli isolates from patients with urinary tract infections presenting to the emergency department

Infection ◽  
2018 ◽  
Vol 46 (3) ◽  
pp. 325-331 ◽  
Author(s):  
Florian Hitzenbichler ◽  
Michaela Simon ◽  
Thomas Holzmann ◽  
Michael Iberer ◽  
Markus Zimmermann ◽  
...  
Keyword(s):  
Emergency Department ◽  
Antibiotic Resistance ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
E Coli ◽  
Tract Infections

scholarly journals COMPARATIVE STUDY OF INCIDENCE RATES AND ANTIBIOGRAM OF CATHETER-ASSOCIATED URINARY TRACT INFECTIONS IN INTENSIVE CARE UNIT VERSUS NON-INTENSIVE CARE UNIT AT A TERTIARY CARE TEACHING HOSPITAL

2021 ◽  
pp. 167-172
Author(s):  
MICAH JOB ◽  
MOBISHA MONACHAN ◽  
RESMI SCARIA ◽  
MERLIN BABU
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Tertiary Care ◽  
Significant Risk ◽  
Incidence Rates ◽  
Antimicrobial Susceptibility Pattern ◽  
Tract Infections

Objective: Catheter-associated urinary tract infections (CAUTI) is the most common HAI which leads to increased hospital stay and morbidity. The study aimed to compare the incidence rates of CAUTI per 1000 catheter days and their antimicrobial susceptibility pattern between intensive care unit (ICU) and non ICU and to determine predisposing risk factors, indications, and outcomes of CAUTI. Methods: A comparative observational study was conducted in ICU and non ICU for a period of 6 months. The sample size of the study was 120. The data were collected, analyzed in terms of both inferential and descriptive statistics. Results: The incidence rate per thousand catheter days in non ICU was more as compared to ICU. The significant risk factors associated with CAUTI were the duration of catheterization and type 2 diabetes mellitus. The majority of the patients were catheterized for indications such as critically ill and unconsciousness followed by measurement of urine output. The outcomes of CAUTI were increased duration of hospitalization and recovery of patients. All the Gram-positive and Gram-negative isolates from non ICU were sensitive to piperacillin + tazobactam and meropenem. All the isolates from ICU and non ICU were resistant to co-trimoxazole. Conclusion: The urinary catheter is an essential part of modern medical care. Unfortunately, when used inappropriately or when left in place for too long, it is a hazard to the patient. This study helps to prevent indiscriminate and irrational use of antibiotics which contribute to emerging of drug resistance strains.

scholarly journals Selection and co-selection of antibiotic resistances among Escherichia coli by antibiotic use in primary care: an ecological analysis

2019 ◽  
Author(s):  
Koen B Pouwels ◽  
Berit Muller-Pebody ◽  
Timo Smieszek ◽  
Susan Hopkins ◽  
Julie V Robotham
Keyword(s):  
Escherichia Coli ◽  
Primary Care ◽  
Antibiotic Resistance ◽  
Urinary Tract ◽  
Respiratory Tract ◽  
Urinary Tract Infections ◽  
Respiratory Tract Infections ◽  
Antibiotic Use ◽  
E Coli ◽  
Tract Infections

AbstractThe majority of studies that link antibiotic usage and resistance focus on simple associations between the resistance against a specific antibiotic and the use of that specific antibiotic. However, the relationship between antibiotic use and resistance is more complex. Here we evaluate which antibiotics, including those mainly prescribed for respiratory tract infections, are associated with increased resistance among Escherichia coli isolated from urinary samples.Monthly primary care prescribing data were obtained from National Health Service (NHS) Digital. Positive E. coli records from urine samples in English primary care (n=888,207) between April 2014 and January 2016 were obtained from the Second Generation Surveillance System. Elastic net regularization was used to evaluate associations between prescribing of different antibiotic groups and resistance against amoxicillin, cephalexin, ciprofloxacin, co-amoxiclav and nitrofurantoin at the clinical commissioning group (CCG) level. England is divided into 209 CCGs, with each NHS practice prolonging to one CCG.Amoxicillin prescribing (measured in DDD/ 1000 inhabitants / day) was positively associated with amoxicillin (RR 1.03, 95% CI 1.01 – 1.04) and ciprofloxacin (RR 1.09, 95% CI 1.04 – 1.17) resistance. In contrast, nitrofurantoin prescribing was associated with lower levels of resistance to amoxicillin (RR 0.92, 95% CI 0.84 – 0.97). CCGs with higher levels of trimethoprim prescribing also had higher levels of ciprofloxacin resistance (RR 1.34, 95% CI 1.10 – 1.59).Amoxicillin, which is mainly (and often unnecessarily) prescribed for respiratory tract infections is associated with increased resistance against various antibiotics among E. coli causing urinary tract infections. Our findings suggest that when predicting the potential impact of interventions on antibiotic resistances it is important to account for use of other antibiotics, including those typically used for other indications.Author summaryAntibiotic resistance is increasingly recognised as a threat to modern healthcare. Effective antibiotics are crucial for treatment of serious bacterial infections and are necessary to avoid that complicated surgical procedures and chemotherapy becoming life-threatening. Antibiotic use is one of the main drivers of antibiotic resistance. The majority of antibiotic prescriptions are prescribed in primary care, however, a large proportion of these antibiotic prescriptions are unnecessary. Understanding which antibiotics are causing antibiotic resistance to what extent is needed to prevent under- or over-investment in interventions lowering use of specific antibiotics, such as rapid diagnostic tests for respiratory tract infection.We have statistically evaluated which antibiotics are associated with higher and lower levels of antibiotic resistance against common antibiotics among Escherichia coli bacteria sampled from the urinary tract by comparing antibiotic prescribing and resistance in different geographical areas in England. Our model shows that amoxicillin, the most commonly used antibiotic in England and mainly used for respiratory tract infections, is associated with increased resistance against several other antibiotics among bacteria causing urinary tract infections. The methods used in this study, that overcome several of the limitations of previous studies, can be used to explore the complex relationships between antibiotic use and antibiotic resistance in other settings.

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