Background: Considering the importance of empirical antibiotic treatment before obtaining urine culture results, it is necessary to know the pattern of microbial sensitivity to antibiotics to proper manage urinary tract infection (UTI). The present research aimed at determining type of pathogens causing UTI and the pattern of antibiotic sensitivity in urine cultures of hospitalized patients in Hamadan, Iran. Methods: This cross-sectional study was conducted on 120 individuals (including 60 cases as the hospital-acquired infection and 60 cases as the community-acquired infection group). Clinical and demographic data were obtained from all the examined samples, and the pattern of antibiotic sensitivity in the selected cases was investigated. Results: According to the results, most of the isolates were resistant to commonly used antibiotics in the treatment of UTIs. A significant increase was observed in drug resistance to ciprofloxacin, levofloxacin, cotrimoxazole, and ceftriaxone, especially in community-acquired cases. In community-acquired UTIs from the gram-negative pathogen, E.coli showed the highest drug sensitivity to imipenem (100%) and Fosfomycin (95%) and the highest drug resistances were observed for ciprofloxacin (62.5%) and levofloxacin (60%). In the cases of E.coli acquired from the hospital, resistance to fluoroquinolones, ceftriaxone and cefepime increased, while the sensitivity to meropenem, imipenem, and piperacillin-tazobactam was 80.6%, 87.1% and 90%, respectively. Conclusion: It is necessary to determine the frequency and regional antibiotic sensitivity patterns of bacteria causing UTIs to provide an effective and proper protocol for the management and treatment of serious and critical patients with UTIs.

Background: Considering the importance of empirical antibiotic treatment before obtaining urine culture results, it is necessary to know the pattern of microbial sensitivity to antibiotics to proper manage urinary tract infection (UTI).The present research aimed at determining type of pathogens causing UTI and the pattern of antibiotic sensitivity in urine cultures of hospitalized patients in Hamadan, Iran.Methods: This cross-sectional study was conducted on 120 individuals (including 60 cases as the hospital-acquired infection and 60 cases as the community-acquired infection group). Clinical and demographic data were obtained from all the examined samples, and the pattern of antibiotic sensitivity in the selected cases was investigated.Results: According to the results, most of the isolates were resistant to commonly used antibiotics in the treatment of UTIs. A signi cant increase was observed in drug resistance to cipro oxacin, levo oxacin, cotrimoxazole, and ceftriaxone, especially in community-acquired cases. In community-acquired UTIs from the gram-negative pathogen, E.coli showed the highest drug sensitivity to imipenem (100%) and Fosfomycin (95%) and the highest drug resistances were observed for cipro oxacin (62.5%) and levo oxacin (60%). In the cases of E.coli acquired from the hospital, resistance to uoroquinolones, ceftriaxone and cefepime increased, while the sensitivity to meropenem, imipenem, and piperacillintazobactam was 80.6%, 87.1% and 90%, respectively. Conclusion: It is necessary to determine the frequency and regional antibiotic sensitivity patterns of bacteria causing UTIs to provide an effective and proper protocol for the management and treatment of serious and critical patients with UTIs.

Background The common regression models included estimated glomerular filtration rate (eGFR) in the continuous and categorical form for predicting the mortality in COVID-19 inpatients. However, the relationship may be non-linear, and categorizing implies a loss of information. This study aimed to assess the effect of eGFR on admission on death within 30 days among COVID-19 inpatients using flexible and smooth transformations of eGFR and compare the results against the common models. Methods A retrospective study was conducted on hospitalized COVID-19 patients between April 2019 and July 2019 in Hamadan, Western Iran. The effect of eGFR on the death within 30 days was evaluated using different modeling: categorization, linear, unrestricted cubic spline (USC) with 4 knots, and fractional polynomial (FP). The results adjusted for older age and intensive care unit (ICU) admission. Discrimination power and model performance of the best-fitting model was evaluated using the area under the ROC (AUROC) and Brier score. Results In total, 2945 patients (median age 61 years; interquartile range 48–73 years) were included, of whom the mortality rate was 9.23%. The relationship between the eGFR and death within 30 days is non-linear, so the degree-2 FP with powers (− 2, − 1) is the best-fitting model. Using the FP model, the risk increased exponentially in eGFR < 45 and then increased linearly and slowly. The AUROC of the FP model involving eGFR, older age, and ICU admission was 0.92 (95% CI 0.90–0.93) with a Brier score of 0.09. Conclusion There is a non-linear and asymmetric relationship between eGFR and death within 30 days among COVID-19 inpatients. Kidney function can be measured in COCID-19 patients on admission to know better understanding about prognosis of the patients.