Risk Factors for Community-Acquired Urinary Tract Infection by Extended-Spectrum β-Lactamase–Producing Organisms in Children

2015 ◽  
Vol 10 (02) ◽  
pp. 045-046 ◽  
Author(s):  
Shalini Sharma ◽  
Padmanabhan Ramachandran ◽  
Uma Sekar ◽  
Padmasani Venkat Ramanan
2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S243-S243
Author(s):  
Sukhjit Takhar ◽  
Anusha Krishnadasan ◽  
Gregory J Moran ◽  
William Mower ◽  
Kavitha Pathmarajah ◽  
...  

Abstract Background Gram-negative infections due to extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae, and carbapenem-resistant Enterobacteriaceae (CRE) and non-fermenting (CR-NF) strains, are increasingly encountered. Study objectives were to determine prevalence and associated risk factors and outcomes for these strains among emergency department patients hospitalized for urinary tract infection (UTI) at 11 US hospitals. Methods This was a prospective observational study of patients ≥18 years hospitalized for UTI. Clinical data were collected at the index visit. Urine was obtained for culture and susceptibility testing. Electronic medical record and telephone follow-up were conducted after 30 days for site laboratory results, treatment, and clinical outcomes. Positive culture was defined as 1 uropathogen with growth at ≥104 cfu/mL, or 2 with 1 or both at ≥105 cfu/mL, or ≥3 with 1 or 2 at ≥105 cfu/mL. Isolates with ceftriaxone (CRO) or meropenem MIC >1 μg/mL will undergo reference laboratory (IHMA, Inc., Schaumburg, IL) susceptibility testing, including against newer antibiotics and cefiderocol. Results We enrolled 774 participants between 2018 and 2019; 289 (37.3%) excluded due to urine culture not done, no growth, or contamination. Of 485 culture-positive participants (median age 56 years, 62.0% female), 432 (89.1%) grew 1 uropathogen, 48 (9.9%) 2, and 5 (1.0%) ≥3. Prevalences of CRO-resistant Enterobacteriaceae, CRE, and CR-NF were 19.9%, 2.1%, and 10.7%, respectively. At sites, 95.7% of CRO-resistant Enterobacteriaceae isolates were ESBL. Among participants with any or no antibiotic resistance risk factors, i.e., antibiotics, hospitalization, long-term care, or travel within 90 days, prevalence of CRO-resistant Enterobacteriaceae was 68/228 (29.8%) and 10/155 (6.5%), respectively. Among those with CRO-resistant vs. susceptible Enterobacteriaceae infections, ICU admission and death occurred in 9.9% vs. 6.6% and 3.7% vs. 1.0%, with median time home over 30 days, 24 vs. 27 days, respectively. Conclusion Among US hospitalized patients with UTI, infections due to CRE remain uncommon; however, ESBL and CR-NF now account for a substantial proportion of cases and are associated with resistance risk factors and worse outcomes. Disclosures All authors: No reported disclosures.


2019 ◽  
Vol 61 (11) ◽  
pp. 1127-1132 ◽  
Author(s):  
Jumana H Albaramki ◽  
Tariq Abdelghani ◽  
Alaa Dalaeen ◽  
Fareed Khdair Ahmad ◽  
Abeer Alassaf ◽  
...  

2018 ◽  
Vol 1 (3) ◽  
pp. 26-38
Author(s):  
Abdulghani Mohamed Alsamarai ◽  
Shler Ali Khorshed

Background: Urinary tract infection is common with health impact in women and characterised by failure to treatment and recurrent episodes. Aim: This study was conducted to determine the risk factors for the development of urinary tract infection in diabetic and pregnant women in comparison to student female. Materials and methods: A prospective cross-sectional study conducted during the period from 1st of June 2015 to the end of January 2016. The population included in the study are 563 women, of them 425 were outpatients, and 138 were inpatients. Their age range between 18 and 80 years, with a mean age of 33.59±15.29 years. Urine samples collected and cultured on blood agar and MacConkey agar by spread plate technique. Bacterial colonies with different morphology were selected, purified and identified according to their biochemical characteristics using conventional standard methods. Results: In diabetic women, there were no significant difference in mean age and BMI values between culture positive and culture negative groups. However, pus cell mean scale was significantly higher [P=0.000] in women with urinary tract infection [1.76±1.25] than in those with negative culture [0.69±1.00]. In pregnant women, BMI mean value was significantly [P=0.013] lower in pregnant women with UTI [26.14] as compared to those without infection [26.99]. Pus cell scale mean value was significantly [P=0.000] higher in pregnant women with UTI [1.55] than women with negative UTI [0.85]. While there was no significant difference in mean age between UTI positive and negative pregnant women. In female student, there was a significant difference between UTI infected and non-infected in mean age [P=0.041] and pus cell scale [P=0.000]. However, BMI was not significantly different between infected and non-infected female student. Other risk factors association are variables in the 3 groups when analysed using X2, while AUC and OR show different trends of association between risk factors and UTI. Conclusion: BMI, pus cell scale, child number, delivery method, operation history and hospital setting were significantly associated with culture positivity in the 3 studied groups as determined by AUC. While OR confirmed association with pus sale scale in the 3 groups.


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