A1.32 Bacterial spectrum and antibiotic resistance of uropathogens in hospitalized urological patients with urinary tract infections (1994–2004) and consequences for empiric antibiotic therapy

2005 ◽  
Vol 26 ◽  
pp. S75-S76
Keyword(s):  
Antibiotic Resistance ◽  
Urinary Tract ◽  
Antibiotic Therapy ◽  
Urinary Tract Infections ◽  
Empiric Antibiotic Therapy ◽  
Bacterial Spectrum ◽  
Empiric Antibiotic ◽  
Tract Infections

scholarly journals Efficacy of Empiric Treatment of Urinary Tract Infections in Neonates and Young Infants

2019 ◽  
Vol 6 ◽  
pp. 2333794X1985799
Author(s):  
James W. Antoon ◽  
Paige J. Reilly ◽  
Erin H. Munns ◽  
Alan Schwartz ◽  
Jacob A. Lohr
Keyword(s):  
Antibiotic Resistance ◽  
Urinary Tract ◽  
Length Of Stay ◽  
Urinary Tract Infections ◽  
Age Group ◽  
Prolonged Length ◽  
Enterococcal Infection ◽  
Young Infants ◽  
Empiric Antibiotic ◽  
Tract Infections

Background. The antibiotic resistance patterns of young infants with urinary tract infections (UTIs) have evolved over the past 2 decades. Whether current empiric antibiotic regimens are sufficient in this age group is unknown. Methods. A retrospective review of patients aged 0 to 60 days admitted with a UTI discharge diagnosis. Results. Overall susceptibility to empiric antibiotics was 87%. Antibiotic resistance and length of stay were highest among those who were afebrile, those admitted to the intensive care unit, and those with culture diagnosis of enterococcal infection. The sensitivity and specificity of ultrasound as a screening tool for genitourinary anomaly was 70% and 40%, respectively, with a positive predictive value of 31.8%. Conclusions. Empiric antibiotic regimens cover a high percentage of UTIs in infants. However, high rates of resistance and prolonged length of stay in patients with enterococcal infection highlight the need for continued surveillance of such patients in this age group.

scholarly journals Urinary tract infections in children: an overview of diagnosis and management

2019 ◽  
Vol 3 (1) ◽  
pp. e000487 ◽  
Author(s):  
Jonathan Kaufman ◽  
Meredith Temple-Smith ◽  
Lena Sanci
Keyword(s):  
Antibiotic Resistance ◽  
Urinary Tract ◽  
Antibiotic Therapy ◽  
Bacterial Infection ◽  
Urinary Tract Infections ◽  
Urine Culture ◽  
Sample Collection ◽  
Diagnosis And Management ◽  
Duration Of Therapy ◽  
Tract Infections

Urinary tract infections (UTIs) are a common and potentially serious bacterial infection of childhood. History and examination findings can be non-specific, so a urine sample is required to diagnose UTI. Sample collection in young precontinent children can be challenging. Bedside dipstick tests are useful for screening, but urine culture is required for diagnostic confirmation. Antibiotic therapy must be guided by local guidelines due to increasing antibiotic resistance. Duration of therapy and indications for imaging remain controversial topics and guidelines lack consensus. This article presents an overview of paediatric UTI diagnosis and management, with highlights of recent advances and evidence updates.

scholarly journals 1677. Evaluation of Optimal Treatment for Urinary Tract Infections in Outpatient Clinics at an Academic Medical Center

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S824-S824
Author(s):  
Jennifer Walters ◽  
Jihye Kim ◽  
Michael Stevens
Keyword(s):  
Internal Medicine ◽  
Urinary Tract ◽  
Antibiotic Therapy ◽  
Urinary Tract Infections ◽  
Inappropriate Prescribing ◽  
Outpatient Clinics ◽  
Empiric Antibiotic Therapy ◽  
Empiric Antibiotics ◽  
History Of ◽  
Tract Infections

Abstract Background Inappropriate prescribing of antibiotics is an important modifiable risk factor for antibiotic resistance. The Joint Commission has identified the need for outpatient antimicrobial stewardship efforts. The purpose of this study was to assess the incidence of optimal empiric antibiotic therapy for urinary tract infections (UTIs) in outpatient clinics at VCU Health. Methods This was a retrospective study of patients seen in internal medicine (IM) and urology clinics between July 1, 2018 and June 30, 2019. Patients were included if they were ≥ 18 years old, had a diagnosis of UTI per ICD-10 code, and received a prescription to treat a UTI at the visit. Patients were excluded if they had a concurrent infection, currently prescribed antibiotics, or pregnant. The primary outcome was to evaluate the incidence of optimal empiric treatment for UTIs. Appropriateness of antibiotic therapy was assessed based on prior culture data along with our institutional UTI treatment guideline. Results Two hundred and twenty-six patients were included: 136 in IM clinics and 90 in urology clinics. Patients in the IM clinics were significantly older (mean age 64.8 vs. 60.5, p= 0.033) and more were female (88% vs. 38%, p< 0.001). More patients in the urology clinics had a history of a UTI within 24 months (72% vs. 57%, p= 0.016), history of fluoroquinolone-resistant Gram-Negative UTIs (35% vs. 13%, p= 0.007), and history of genitourinary cancer (28% vs. 1%, p< 0.001). Overall, 61% of patients were treated with optimal empiric antibiotics. Incidence of optimal prescribing in the IM clinics was significantly higher compared to urology clinics (69% vs 49%, p= 0.002). See table 1 for additional results. Table 1. Optimal UTI Treatment in Internal Medicine Clinics vs Urology Clinics Conclusion IM clinics more frequently prescribed optimal empiric antibiotics for UTIs compared to urology clinics. Resident prescribers were more likely to prescribe optimal empiric therapy. Presence of a beta-lactam allergy was not predictive of optimal prescribing. These data highlight opportunities for antibiotic therapy optimization for UTIs at our health system. Disclosures All Authors: No reported disclosures

scholarly journals THE CURRENT STATE OF ANTIBIOTIC RESISTANCE AND THE COMPOSITION OF PATHOGENS OF URINARY TRACT INFECTIONS IN PREGNANT WOMEN

2018 ◽  
Vol 6 (2) ◽  
pp. 13-20 ◽  
Author(s):  
K. L. Lokshin ◽  
V. N. Shirshov ◽  
A. S. Popko ◽  
Yu. L. Demidko ◽  
N. D. Luchenkova
Keyword(s):  
Antibiotic Resistance ◽  
Urinary Tract ◽  
Antibiotic Therapy ◽  
Pregnant Women ◽  
Urinary Tract Infections ◽  
Asymptomatic Bacteriuria ◽  
Resistance Rate ◽  
Acute Cystitis ◽  
E Coli ◽  
Tract Infections

Introduction.The main treatment component of asymptomatic bacteriuria, acute cystitis and pyelonephritis in pregnant women is antibiotic therapy, which in many patients is prescribed empirically. For successful selection of the drug, it is necessary to know both the structure of pathogens and the current profile of their antibiotic resistance.Purpose of research.The study of species composition and resistance to antibiotics of bacteria that cause urinary tract infections (UTIs) in pregnant women in the Moscow RegionMaterials and methods.The study included 104 pregnant women with uncomplicated UTIs who were observed and treated at the Lapino Clinical Hospital between 2016 and 2017. The material for bacteriological studies was the midstream portion of urine or urine collected by a catheter.Results.90 patients had asymptomatic bacteriuria, 10 had acute cystitis, and 4 had acute gestational pyelonephritis. The structure of the pathogens of UTI is presented: E. coli, Enterococcus faecalis, Klebsiella pneumoniae, Proteus spp., Staphylococcus spp., Streptococcus spp., Enterobacter cloacae. The most frequently detected pathogens were E. coli (67.3%) and E. faecalis (50%). Resistance rate of E.coli strains more than 20% was detected to ampicillin (36.4%), amoxicillin / clavulanate (23.2%), trimethoprim / sulfamethoxazole (27.4%), nalidixic acid (20.7%), cephalosporins 2 and 3 generation (respectively, 25.7% and 24.3%). Resistance rate more than 20% in Enterobacteriaceae family strains was detected to trimethoprim/sulfamethoxazole (24.4%), nalidixic acid (20.7%), cephalosporins 2 generations (21.7%). Antibiotic resistance of E.coli and other Enterobacteriaceae family taxons less than 10% was noted only with respect to carbapenems (0%) and fosfomycin (1.5% and 3.5%, respectively).Conclusions.It is expedient to use the obtained data on the composition and sensitivity profile of uropathogens in UTIs in pregnant women when choosing starting empirical antibiotic therapy. Disclosure: The study did not have sponsorship. The authors have declared no conflicts of interest.

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