Clinical characteristics and antimicrobial susceptibility pattern of hospitalised patients with community-acquired urinary tract infections at a regional hospital in 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.

Length of stay and mortality associated with healthcare-associated urinary tract infections: a multi-state model

“…5e10 The emergence of antimicrobial resistance is of particular concern with respect to urinary tract infections (UTIs), since the majority of causative agents are Gram-negative bacteria. 11 This adds further value to endeavours that aim to understand the burden of UTIs and interventions to reduce their incidence.…”

Type 2 diabetes mellitus and antibiotic-resistant infections: a systematic review and meta-analysis

“…Reports were informed by data collected since 1989 20 –2017. 21 22 The studies were conducted in Argentina, 16 Bangladesh, 23 24 Belgium, 25 Brazil, 26 27 Canada, 28 29 China, 21 30–32 Egypt, 33 Finland, 34 France, 35–37 Germany, 37 Greece, 38 Guyana, 22 India, 39 Italy, 37 40 Israel, 28 41–43 Japan, 44 Korea, 45 46 Madagascar, 47 Nepal, 48 Netherlands, 15 Norway, 49 Pakistan, 50 Poland, 51 Singapore, 20 52 53 Spain, 37 54–57 Sweden, 34 58 USA, 37 59–75 Taiwan 76 77 and Thailand. 78 …”

Risk of urinary tract infection symptoms recurrence in women

“…Ampicillin, ampicillin/sulbactam, fluoroquinolone are regarded as alternative treatment choices [ 24 ]. Previous study results showed that E. coli has lower susceptibility rates for trimethoprim-sulfamethoxazole (49%), ampicillin (30%), ampicillin/sulbactam (34%), but high susceptibility rate (81%) for cefazolin [ 25 ]. In our study, we had confidence for cefazolin efficacy due to high susceptibility rate record (>80%) against E. coli in our hospital experience.…”