Luke F Chen1, Chun-Ting Chiu2, Jui-Yo Lo3, Si-Yuan Tsai3, Li-Shiu Weng4, Deverick J Anderson1, Huan-Sheng Chen5. 1. Program for Infection Prevention and Healthcare Epidemiology, Division of Infectious Diseases and International Health, Department of Medicine, Duke University Medical Center, Durham, North Carolina, 27710, USA. 2. Medical Clinic at Taoyuan International Airport, Landseed Hospital, Taiwan. 3. Center of Infection Control, Landseed Hospital, Taiwan. 4. Department of Pathology and Laboratory, Landseed Hospital, Taiwan. 5. Center of Infection Control, Landseed Hospital, Taiwan ; Division of Infectious Diseases, Department of Internal Medicine, Landseed Hospital, Taiwan.
Abstract
BACKGROUND: Community-acquired urinary tract infection (UTI) is the most common bacterial infection encountered at hospitals. Effective empirical antibiotic therapy relies on updated epidemiological data. AIM: We described the epidemiology of patients with urosepsis presenting to a community hospital in Taiwan in order to assess the appropriateness of empirical therapy. METHODS: Retrospective cohort study of hospitalized adult patients with UTI from January 1 to December 31 in 2010. The clinical and microbiological characteristics were analyzed using descriptive statistics. Logistic regression analysis was performed to determine predictors of antibiotic resistance. FINDINGS: A total of 420 consecutive patients with 599 isolates were identified. Most patients were >=65 years old and women (75.4%), and 114 patients (27.1%) had bacteremia. Escherichia coli (69%) was the most common organism. Cefazolin was effective against E. coli, K. pneumoniae, and P. mirabilis in greater than 80% of the cases. In male patients, urinary catheter and renal stone were independent predictors for cefazolin resistance; while diabetes mellitus and malignancy were predictors among female patients. CONCLUSION: Patients admitted with UTI should be screened to identify risk factors for bacteremia and antimicrobial resistance. The treatment guideline in Taiwan needs to be revised in the current era of increasing antimicrobial resistance.
BACKGROUND: Community-acquired urinary tract infection (UTI) is the most common bacterial infection encountered at hospitals. Effective empirical antibiotic therapy relies on updated epidemiological data. AIM: We described the epidemiology of patients with urosepsis presenting to a community hospital in Taiwan in order to assess the appropriateness of empirical therapy. METHODS: Retrospective cohort study of hospitalized adult patients with UTI from January 1 to December 31 in 2010. The clinical and microbiological characteristics were analyzed using descriptive statistics. Logistic regression analysis was performed to determine predictors of antibiotic resistance. FINDINGS: A total of 420 consecutive patients with 599 isolates were identified. Most patients were >=65 years old and women (75.4%), and 114 patients (27.1%) had bacteremia. Escherichia coli (69%) was the most common organism. Cefazolin was effective against E. coli, K. pneumoniae, and P. mirabilis in greater than 80% of the cases. In male patients, urinary catheter and renal stone were independent predictors for cefazolin resistance; while diabetes mellitus and malignancy were predictors among female patients. CONCLUSION:Patients admitted with UTI should be screened to identify risk factors for bacteremia and antimicrobial resistance. The treatment guideline in Taiwan needs to be revised in the current era of increasing antimicrobial resistance.
Entities:
Keywords:
Antimicrobial resistance; Community Hospitals; Epidemiology; Guidelines; Urinary tract infection
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