Antimicrobial resistance and associated risk factors in urinary tract infections diagnosed in the emergency department: a retrospective observational study
Abstract
Background: Urinary tract infections (UTIs) are among the most common causes of emergency department admissions and represent a major source of antimicrobial use worldwide. The aim of this study was to determine antimicrobial resistance patterns and associated risk factors among patients diagnosed with UTIs in the emergency department.
Methods: This retrospective observational study included 1,042 adult patients diagnosed with UTIs in the ED of a tertiary referral hospital. Demographic characteristics, clinical findings, urine culture results, antimicrobial susceptibility profiles, and resistance-associated risk factors were analyzed.
Results: Gram-negative bacteria accounted for 74.6% of isolates, with Escherichia coli (43.1%) and Klebsiella spp. (22.3%) being the predominant pathogens. High resistance rates were observed for ciprofloxacin (47.6%), ceftriaxone (47.0%), and trimethoprim-sulfamethoxazole (41.3%). ESBL production and carbapenem resistance were detected in 16.9% and 17.9% of Gram-negative isolates, respectively. Recent antibiotic use, indwelling urinary catheterization, and malignancy were identified as independent risk factors for ESBL positivity. Male sex, malignancy, and indwelling urinary catheterization were independently associated with carbapenem resistance. Among Enterococcus spp. isolates, vancomycin resistance remained very low (0.9%), whereas ampicillin resistance was detected in 23.7% of isolates.
Conclusions: These findings underscore the critical…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 1,042 participants or records.
Read the paper
Related studies
- Horizontal gene transfer in the human gastrointestinal tract: potential spread of antibiotic resistance genes
- Mutation supply and relative fitness shape the genotypes of ciprofloxacin-resistant Escherichia coli
- Genomic Survey of E. coli From the Bladders of Women With and Without Lower Urinary Tract Symptoms
- Characterization of cefotaxime-resistant urinary Escherichia coli from primary care in South-West England 2017–18
- Fitness cost constrains the spectrum of marR mutations in ciprofloxacin-resistant Escherichia coli
- Emerging evidence-based innovative approaches to control catheter-associated urinary tract infection: a review
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.