scholarly journals The Etiology of Nosocomial Infections in Pediatric Patients at the Department of Child Health, School of Medicine Padjadjaran University Hasan Sadikin General Hospital, Bandung

2019 ◽  
Vol 33 (5-6) ◽  
pp. 100-7
Author(s):  
Herry Garna
Keyword(s):  
Klebsiella Pneumoniae ◽  
Pediatric Patients ◽  
Enterobacter Aerogenes ◽  
Skin Infections ◽  
Pseudomonas Sp ◽  
E Coli ◽  
School Of Medicine ◽  
Nosocomial Bacteremia ◽  
Citrobacter Diversus ◽  
Tract Infections

Tbe distribution of pathogens causing nosocomial gastroenteritis was E. coli (69.2%), Salmonella sp (23.1%), rotavirns (6.4%) and Shigella sp (1.3%) . Klebsiella pneumoniae seemed to be the pathogen most frequently associated with nosocomial skin infections (26. 7%), followed by Enterobacter aerogenes (20.0%), E. coli, Ps. Aeruginosa and S. aureus, each in 13.3% and others 03.4%). Salmonella sp was the pathogen most frequently associated with nosocomial bacteremia (20.2%), followed by Klebsiella sp 07.9%), S. a/bus 04.3%), Enterobacter sp 01.9%), Pseudomonas sp (9.5%), S. aureus (9.5%) and others (16. 7%). In nosocomial urinary tract infections, the result was E. coli (32.9%), Klebsiella pneumoniae (20.5%), Enterobacter sp 03. 7%), Citrobacter diversus (6.8%) and others (26.1%). In general, E. coli was the most frequently reported pathogens ( 42.0%), followed by Salmonella sp 07.1%), Klebsiella sp (10.2%), Citrobacter sp (7.2%), S. a/bus (4.5%), Pseudomonas sp (4.2%), S. aureus (3.6%) and others 01.2%), respectively.

scholarly journals Catheter Related Infections in Pediatric Patients

2019 ◽  
Vol 33 (5-6) ◽  
pp. 108-14
Author(s):  
Herry Garna
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Nosocomial Infections ◽  
Pediatric Patients ◽  
Skin Infection ◽  
Enterobacter Aerogenes ◽  
Klebsiella Pneumonia ◽  
Skin Infections ◽  
E Coli ◽  
Frequent Site

During a 9-month prospective study, from August, 1988 to April, 1989, a total number of 4328 hospitalized pediatric patients at the Department of Child Health, Padjadjaran University, Hasan Sadikin General Hospital Bandung, were observed to identify skin and soft tissue nosocomial infections (not included postoperative), especially catheter related injections. The gastroentestinal tract was the most frequent site of nosocomial infections (44.3%), then subsequently followed by skin infection (22.6%), bacteremia (16.3%) and urinary tract infection (14.1%). The most frequent cause of nosocomial skin infections like phlebitis was IVFD occurring in 82 out of 93 patients (88.2%). The overall phlebitis attact rate was 4.2% . When the duration of infusion is devided into 3 groups of 0-36 hours, 37-72 hours and ≥ 73 hours, then it becomes clear that the longer the duration of infusion, the higher the attack rate (x2=8.07, p<0.05). Klebsiella pneumonia seemed to be the pathogen most frequently associated with nosocomial skin infections (26. 7%), followed by Enterobacter aerogenes (20.0%), and then E. coli, Ps. aeruginosa and S. aureus 13.3% each. It could be concluded that the risk of contracting phlebitis from JVFD with a duration  of ≥ 73 hours was. 1.9 times higher than that of less than 72 hours.

Антимікробна резистентність провідних збудників інфекцій сечових шляхів у Києві (Україна)

2017 ◽  
Vol 1 (2) ◽  
pp. 48-60
Author(s):  
A.G. Salmanov ◽  
A.V. Rudenko
Keyword(s):  
Escherichia Coli ◽  
Pseudomonas Aeruginosa ◽  
Klebsiella Pneumoniae ◽  
Staphylococcus Epidermidis ◽  
Klebsiella Oxytoca ◽  
Enterobacter Aerogenes ◽  
Enterobacter Cloacae ◽  
Proteus Vulgaris ◽  
Providencia Rettgeri ◽  
E Coli

Мета роботи — вивчити резистентність до антибіотиків бактеріальних збудників інфекцій сечових шляхів (ІСШ), виділених у пацієнтів урологічного стаціонару в м. Києві. Матеріали і методи. Досліджено 1612 штамів бактерій, виділених із сечі хворих з ІСШ (цистит, уретрит, пієлонефрит), госпіталізованих в урологічне відділення ДУ «Інститут урології НАМН України» у м. Києві протягом 2016 р. Серед пацієнтів переважали жінки — 1201 (74,5 %). Вік хворих становив від 17 до 74 років. Для збору даних використано медичну документацію лікарні. Мікробіологічні дослідження виконано у лабораторії мікробіології ДУ «Інститут урології НАМН України». Аналізували результати культурального дослідження зразків сечі, зібраних за наявності клінічних ознак ІСШ. Дослідження клінічного матеріалу та інтерпретацію отриманих результатів проводили загальноприйнятими методами. Вивчено чутливість уропатогенів до 31 антибіотика дискодифузійним методом відповідно до рекомендацій Інституту клінічних та лабораторних стандартів США (Clinical and Laboratory Standards Institute (CLSI)). Результати та обговорення. Аналіз мікробного спектра сечі виявив домінування серед уропатогенів штамів Escherichia coli (32,0 %), Enterococcus faecalis (19,5 %), Klebsiella pneumoniae (10,9 %), Staphylococcus epidermidis (8,9 %), S. haemolyticus (6,5 %) та Pseudomonas aeruginosa (6,4 %). Частка Enterococcus faecium, Enterobacter aerogenes і Streptococcus viridans становила відповідно 2,5, 2,2 і 1,6 %, Enterobacter cloacae, Klebsiella oxytoca, Acinetobacter baumannii, Proteus vulgaris та Providencia rettgeri — менше 1,0 %. У більшості випадків (69,7 %) мікроорганізми виділено у монокультурі, у решті випадків — у мікробних асоціа- ціях. Високу резистентність до тестованих антибіотиків виявили штами E. aerogenes (45,1 %), E. cloacae (45,7 %), E. faecium (40,9 %), E. faecalis (40,7 %), E. coli (39,9 %), P. aeruginosa (34,0 %), K. pneumoniae (28,6 %). Найбільш активними до уропатогенів були іміпенем (E. coli — 87,6 %, P. aeruginosa — 75,7 %, E. cloacae — 67,3 %, E. aerogenes — 72,6 %, K. pneumoniae — 93,2 %), меропенем (E. coli — 89,1 %, P. aeruginosa — 76,7 %, K. pneumoniae — 82,6 %), лефлоцин (E. coli — 74,5 %, ентерококи — 78,7 %, P. aeruginosa — 76,7 %, E. cloacae — 73,9 %, E. aerogenes — 80,4 %, K. pneumoniae — 83,5 %), амоксицилін/клавуланат (ентерококи — 84,6 %), фурагін (ентерококи — 82,6 %), цефоперазон (K. pneumoniae — 89,2 %, P. aeruginosa — 73,8 %), цефтріаксон (K. pneumoniae — 80,1 %). Висновки. Антибіотикорезистентність збудників ІСШ — важлива терапевтична проблема. Найбільшою активністю до уропатогенів характеризуються іміпенем, меропенем, лефлоцин, амоксицилін/ клавуланат, фурагін, цефоперазон, цефтріаксон, які можна розглядати як препарат вибору для призначення стартової терапії ІСШ. Необхідно здійснювати постійний моніторинг за резистентністю до дії антибіотиків. Політику використання антибіотиків у кожному стаціонарі слід визначати залежно від локальних даних щодо резистентності до протимікробних препаратів.

scholarly journals 1675. Epidemiology of Urinary Tract Infections in the United States, 2009 - 2018

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S823-S823
Author(s):  
Kendra Foster ◽  
Linnea A Polgreen ◽  
Brett Faine ◽  
Philip M Polgreen
Keyword(s):  
United States ◽  
Urinary Tract ◽  
Klebsiella Pneumoniae ◽  
Urinary Tract Infections ◽  
Proteus Mirabilis ◽  
Antibiotic Use ◽  
The United States ◽  
Drug Resistant ◽  
E Coli ◽  
Tract Infections

Abstract Background Urinary tract infections (UTIs) are one of the most common bacterial infections. There is a lack of large epidemiologic studies evaluating the etiologies of UTIs in the United States. This study aimed to determine the prevalence of different UTI-causing organisms and their antimicrobial susceptibility profiles among patients being treated in a hospital setting. Methods We used the Premier Healthcare Database. Patients with a primary diagnosis code of cystitis, pyelonephritis, or urinary tract infection and had a urine culture from 2009- 2018 were included in the study. Both inpatients and patients who were only treated in the emergency department (ED) were included. We calculated descriptive statistics for uropathogens and their susceptibilities. Multi-drug-resistant pathogens are defined as pathogens resistant to 3 or more antibiotics. Resistance patterns are also described for specific drug classes, like resistance to fluoroquinolones. We also evaluated antibiotic use in this patient population and how antibiotic use varied during the hospitalization. Results There were 640,285 individuals who met the inclusion criteria. Females make up 82% of the study population and 45% were age 65 or older. The most common uropathogen was Escherichia Coli (64.9%) followed by Klebsiella pneumoniae (8.3%), and Proteus mirabilis (5.7%). 22.2% of patients were infected with a multi-drug-resistant pathogen. We found that E. Coli was multi-drug resistant 23.8% of the time; Klebsiella pneumoniae was multi-drug resistant 7.4%; and Proteus mirabilis was multi-drug resistant 2.8%. The most common antibiotics prescribed were ceftriaxone, levofloxacin, and ciprofloxacin. Among patients that were prescribed ceftriaxone, 31.7% of them switched to a different antibiotic during their hospitalization. Patients that were prescribed levofloxacin and ciprofloxacin switched to a different antibiotic 42.8% and 41.5% of the time, respectively. Conclusion E. Coli showed significant multidrug resistance in this population of UTI patients that were hospitalized or treated within the ED, and antibiotic switching is common. Disclosures All Authors: No reported disclosures

scholarly journals Antimicrobial Resistance Patterns and ESBL of Uropathogens Isolated from Adult Females in Najran Region of Saudi Arabia

2021 ◽  
Vol 11 (3) ◽  
pp. 650-658
Author(s):  
Mohammed Yahia Alasmary
Keyword(s):  
Escherichia Coli ◽  
Saudi Arabia ◽  
Antimicrobial Resistance ◽  
Klebsiella Pneumoniae ◽  
Urine Samples ◽  
Klebsiella Species ◽  
E Coli ◽  
Government Hospitals ◽  
Resistance Patterns ◽  
Tract Infections

Background: To explore the prevalence of urinary tract infections (UTIs) among female patients in the Najran region of Saudi Arabia and determine their antimicrobial resistance pattern. Methods: This study was conducted on 136 urine samples collected from outpatient departments (OPDs) of the different government hospitals in the Najran region of Saudi Arabia. Over one year, the results of susceptibility testing reports of outpatient midstream urine samples from three government hospitals were prospectively evaluated. Results: Of 136 urine samples, only 123 (90.45%) were found to show significant growth for UTIs, from which 23 different uropathogens were identified. Escherichia coli (58.5%) was the most commonly isolated organism, followed by Klebsiella pneumoniae (8.1%). The isolated microorganism showed increased resistance patterns from 3.3% to 62.6%, with an overall resistance of 27.19%. Meropenem was the most effective antimicrobial, followed by amikacin and ertapenem (0.47%, 0.91%, and 1.5% resistance, respectively). At the same time, ampicillin and cephazolin were the least (62.6% and 59.5% resistance, respectively) effective. Overall, eleven (8.94%) uropathogens isolates were ESBLs, among which there were eight (6.5%) Escherichia coli, one (0.81%) Klebsiella pneumoniae, one (0.81%) Klebsiella oxytoca, and one (0.81%) Citrobacter amalonaticus. Conclusions: E. coli remains the most commonly isolated causative uropathogens, followed by Klebsiella species. The prevalence of pathogenic E. coli and Klebsiella species underscores the importance of developing cost-effective, precise, and rapid identification systems to minimize public exposure to uropathogens. Antibiotic susceptibility data revealed that most of the isolates were resistant to the majority of the antibiotics. The patients with UTIs in the Najran region of Saudi Arabia are at a high risk of antibiotic resistance, leading to significant problems in outpatient department (OPD) treatment outcomes and raising the alarm for the physician to change their empiric treatment.

scholarly journals Dissemination of the blaNDM-5 Gene via IncX3-Type Plasmid among Enterobacteriaceae in Children

mSphere ◽  
2020 ◽  
Vol 5 (1) ◽  
Author(s):  
Dongxing Tian ◽  
Bingjie Wang ◽  
Hong Zhang ◽  
Fen Pan ◽  
Chun Wang ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Drug Resistance ◽  
Gene Transfer ◽  
Horizontal Gene Transfer ◽  
Klebsiella Pneumoniae ◽  
Pediatric Patients ◽  
Transmission Mechanism ◽  
Klebsiella Aerogenes ◽  
Content Type ◽  
E Coli

ABSTRACT The continuous emergence of novel New Delhi metallo-β-lactamase-5 (NDM-5)-producing Enterobacteriaceae isolates is receiving more and more public attention. Twenty-two NDM-5-producing strains were identified from 146 carbapenemase-producing Enterobacteriaceae (CRE) strains isolated from pediatric patients between January and March 2017, indicating that the blaNDM-5 gene has spread to children. All 22 isolates, including 16 Klebsiella pneumoniae strains, four Klebsiella aerogenes strains, and two Escherichia coli strains, showed significantly high resistance to β-lactam antibiotics (except aztreonam) but remained susceptible to tigecycline and colistin. K. pneumoniae and K. aerogenes strains were respectively defined as homologous clonal isolates by pulsed-field gel electrophoresis (PFGE). Multilocus sequence typing (MLST) results confirmed the genetic relatedness with all K. pneumoniae strains belonging to sequence type (ST) 48. Two E. coli isolates (ST617 and ST1236) were considered genetically unrelated. Twenty-two blaNDM-5 plasmids were positive for the IncX3 amplicon and showed almost identical profiles after digestion with HindIII and EcoRI. Four representative strains (K. pneumoniae K725, K. aerogenes CR33, E. coli Z214, and E. coli Z244) were selected for further study. Plasmids harboring blaNDM-5 showed strong stability in both clinical isolates and transconjugants, without apparent plasmid loss after 100 serial generations. S1-PFGE followed by Southern blot analysis demonstrated that the blaNDM-5 gene was located on an ∼46-kb plasmid. Plasmid sequences of pNDM-K725, pNDM-CR33, and pNDM-Z214 were almost identical but were slightly different from that of pNDM-Z244. Compared with pNDM-Z244, ΔISAba125 and partial copies of IS3000 were missing. The genetic backgrounds of the blaNDM-5 gene in four strains were slightly different from that of the typical pNDM_MGR194. This study comprehensively characterized the horizontal gene transfer of the blaNDM-5 gene among different Enterobacteriaceae isolates in pediatric patients, and the IncX3-type plasmid was responsible for the spread. IMPORTANCE The emergence of CRE strains resistant to multiple antibiotics is considered a substantial threat to human health. Therefore, all the efforts to provide a detailed molecular transmission mechanism of specific drug resistance can contribute positively to prevent the further spread of multidrug-resistant bacteria. Although the new superbug harboring blaNDM-5 has been reported in many countries, it was mostly identified among E. coli strains, and the gene transfer mechanism has not been fully recognized and studied. In this work, we identified 22 blaNDM-5-positive strains in different species of Enterobacteriaceae, including 16 Klebsiella pneumoniae strains, four Klebsiella aerogenes strains, and two Escherichia coli strains, which indicated the horizontal gene transfer of blaNDM-5 among Enterobacteriaceae strains in pediatric patients. Moreover, blaNDM-5 was located on a 46-kb IncX3 plasmid, which is possibly responsible for this widespread horizontal gene transfer. The different genetic contexts of the blaNDM-5 gene indicated some minor evolutions of the plasmid, based on the complete sequences of the blaNDM-5 plasmids. These findings are of great significance to understand the transmission mechanism of drug resistance genes, develop anti-infection treatment, and take effective infection control measures.

Shellac Formulations To Reduce Epiphytic Survival of Coliform Bacteria on Citrus Fruit Postharvest†

2001 ◽  
Vol 64 (11) ◽  
pp. 1756-1760 ◽  
Author(s):  
RAYMOND G. McGUIRE ◽  
ROBERT D. HAGENMAIER
Keyword(s):  
Escherichia Coli ◽  
Klebsiella Pneumoniae ◽  
Limit Of Detection ◽  
Citrus Fruit ◽  
Enterobacter Aerogenes ◽  
Coliform Bacteria ◽  
Undetectable Level ◽  
Neutral Solution ◽  
E Coli ◽  
Epiphytic Survival

Survival of the coliform bacteria Enterobacter aerogenes and Escherichia coli was monitored in a neutral carboxyme-thylcellulose formulation and in shellac formulations with various pH and concentrations of ethanol and the preservative paraben; populations were subsequently measured from the surface of citrus fruit coated with these formulations. Numbers of the two bacteria increased over 24 h from 106 CFU/ml to approximately 108 CFU/ml in the carboxymethylcellulose solution, but over this time numbers remained little changed in the neutral solution of shellac. The Enterobacter was more tolerant of alcohol over a 3-h period; although its numbers in a shellac solution with 10% ethanol dropped from more than 106 CFU/ml to just over 103 CFU/ml, E. coli and a third species, Klebsiella pneumoniae, declined toward the limit of detection (5 CFU/ml) during this time. The addition of morpholine to increase the formulation pH to 9.0 caused numbers of bacteria to plummet to an undetectable level within 30 to 60 min. On Ruby Red grapefruit and Valencia oranges in storage at 13°C numbers of E. aerogenes and E. coli declined over 2 weeks from 105 CFU/cm2 to less than 2.5 × 101, but most of the loss in numbers occurred within 1 day. Numbers remained significantly less on shellacked fruit compared with those applied in the carboxymethylcellulose coating, and a shellac coating prepared from a pH 9 solution was more toxic to these species than one in which 12% ethanol had been added to the neutral formulation. The addition of the preservative paraben in the basic shellac was further inhibitory.

Comparison of VRB and VRB-2 Agars for Recovery of Stressed Coliforms From Stored Acidified Half-and-Half1

1982 ◽  
Vol 45 (7) ◽  
pp. 584-585 ◽  
Author(s):  
C. L. REBER ◽  
R. T. MARSHALL
Keyword(s):  
Escherichia Coli ◽  
Klebsiella Pneumoniae ◽  
Enterobacter Aerogenes ◽  
Coliform Bacteria ◽  
E Coli ◽  
Culture Viability

Half-and-half was acidified with delta-gluconolactone, inoculated with three species of coliform bacteria, stored for 31 days at 5 °C, and examined for numbers of viable coliforms on VRB and VRB-2 agars. Loss of culture viability was logarithmic with recovery of 50 and 10% of initial numbers on days 7 and 30, respectively. Escherichia coli had significantly more recoverable injured cells than did Enterobacter aerogenes or Klebsiella pneumoniae. As time of storage increased, the proportion of injured to noninjured cells also increased. However, the maximal number of injured cells was on the thirteenth day of storage of E. coli-inoculated product. VRB-2 agar averaged 20% higher in productivity than VRB agar.

scholarly journals Nationwide Study of the Prevalence, Characteristics, and Molecular Epidemiology of Extended-Spectrum-β-Lactamase-Producing Enterobacteriaceae in France

2007 ◽  
Vol 52 (2) ◽  
pp. 786-789 ◽  
Author(s):  
Muriel Galas ◽  
Jean-Winoc Decousser ◽  
Nelly Breton ◽  
Thierry Godard ◽  
Pierre Yves Allouch ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Klebsiella Pneumoniae ◽  
Molecular Epidemiology ◽  
Molecular Analysis ◽  
Enterobacter Aerogenes ◽  
Nationwide Study ◽  
E Coli ◽  
Extended Spectrum ◽  
Prevalent Species

ABSTRACT Among 10,872 isolates of Enterobacteriaceae from a nationwide study of 88 French hospitals in 2005, 169 (1.7%) expressed an extended-spectrum β-lactamase. The most prevalent species were Escherichia coli (48.5%), Enterobacter aerogenes (23.7%), and Klebsiella pneumoniae (14.8%). Molecular analysis underlined the polyclonal spread of CTX-M-expressing E. coli, primarily isolates of the CTX-M-1 subgroup.

scholarly journals Microevolution infimHGene of Mucosa-Associated Escherichia coli Strains Isolated from Pediatric Patients with Inflammatory Bowel Disease

2012 ◽  
Vol 80 (4) ◽  
pp. 1408-1417 ◽  
Author(s):  
Valerio Iebba ◽  
Maria Pia Conte ◽  
Maria Stefania Lepanto ◽  
Giovanni Di Nardo ◽  
Floriana Santangelo ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Pediatric Patients ◽  
Environmental Changes ◽  
Mucosal Inflammation ◽  
Content Type ◽  
E Coli ◽  
Inflammatory Bowel ◽  
Tract Infections

ABSTRACTSeveral studies reported increased numbers of mucosa-associatedEscherichia colistrains in patients with inflammatory bowel disease (IBD), encompassing Crohn's disease (CD) and ulcerative colitis (UC). The majority ofE. colistrains possess type 1 fimbriae, whose tip fibrillum protein, FimH, naturally undergoes amino acid replacements, an important process in the adaptation of commensalE. colistrains to environmental changes, like those observed in IBD and urinary tract infections. In this study, we analyzed mutational patterns in thefimHgene of 52 mucosa-associatedE. colistrains isolated from IBD and non-IBD pediatric patients, in order to investigate microevolution of this genetic trait. FimH-positive strains were also phylogenetically typed and tested for their adhesive ability on Caco-2 cells. Specific FimH alleles for each grouping feature were found. Mutations G66S and V27A were related to CD, while mutations A242V, V163A, and T74I were attributed to UC. Otherwise, the G66S, N70S, and S78N mutations were specifically attributed to B2/D phylogroups. The N70S and A119V mutations were related to adhesiveE. colistrains. Phylogroup B2, adhesive, and IBDE. colistrains showed a higher site substitution rate (SSR) in thefimHgene, together with a higher number of mutations. The degree of naïve mucosal inflammation was related to specific FimH alleles. Moreover, we could suggest that the V27A mutation is pathoadaptive for the CD intestinal habitat, while we could also suggest that both the N70S and S78N mutations are related to the more virulentE. coliB2 phylogroup. In conclusion, we found some FimH variants that seem to be more involved than others in the evolution of IBD pathogenesis.

scholarly journals 477. Characterization of Extended-Spectrum Β-Lactamase (ESBL) Producing Gram-negative (GN) Urinary Tract Infections (UTI) in Pediatric Patients

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S233-S233
Author(s):  
Leslie Stach ◽  
Regina Orbach ◽  
Kanokporn Mongkolrattanothai
Keyword(s):  
Urinary Tract ◽  
Pediatric Patients ◽  
Selective Pressure ◽  
Once Daily ◽  
E Coli ◽  
Colony Forming Units ◽  
Amoxicillin Clavulanate ◽  
Tract Infections ◽  
Abnormal Urinary Tract

Abstract Background There has been an increase in antimicrobial resistance among GN pathogens, not only in adults, but also pediatrics. UTIs are common in pediatrics; however, reports of pediatric UTI with ESBL producing GN are limited. Methods All urine cultures positive for ESBL producing GN from 5/1/18 to December 31/18 were retrospectively reviewed. Proven infection (PI) defined as ≥50,000 colony-forming units (CFU)/mL of bacteria plus pyuria or positive leukocyte esterase for catheterized or clean catch specimens. Relapsed infection defined as same pathogen cultured within 30 days of infection. Abnormal urinary tract systems or functions (AUTS) include neurogenic bladder, structural anomalies, or intermittent catheterization. Results A total of 107 urine cultures for ESBL producing GN, from 85 patients, were included. Majority of specimens [78/107 (73%)] were obtained from the ED or outpatient clinics. 43% of specimens were from patients with AUTS. E. coli was the majority (95%) of ESBL isolates. 57% of ESBL producing GNs were susceptible to amoxicillin/clavulanate (AC) or trimethoprim/sulfamethoxazole (TMP/SMX). 88% were nitrofurantoin susceptible. Only 1 isolate was meropenem resistant. Antibiotics (ABX) were prescribed for UTI in 67/107 episodes. However, only 52 episodes were PI. Of these, 38 were empirically treated with oral ABX and 29 with intravenous ABX. The most commonly prescribed empiric ABX was oral cephalexin (25/67, 37%.) Ineffective empiric ABX for UTI was very common, 83% (43/52). Of these, 5/43 never received effective therapy and none had relapse. Most common duration of ABX was 10 days (range 5–17 days.) 43% (23/52) of PI were treated with oral AC or TMP/SMX. 15% (8/52) of PI were treated with nitrofurantoin. 12% of PI were treated with a once-daily aminoglycoside. Only 6% of PI were treated with a carbapenem. Conclusion Many ESBL UTI isolates remain susceptible to oral ABX. Although small numbers, patients treated with ineffective ABX did not return with relapsed infection. Non-carbapenem ABX are a reasonable option to minimize selective pressure or unnecessary use. Empiric narrow-spectrum antibiotic therapy may still be appropriate. Disclosures All authors: No reported disclosures.

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