Resistance of Escherichia coli urinary isolates in emergency department-treated, community-acquired patients over a ten-year period at a community hospital
Abstract
INTRODUCTION: Urinary tract infections (UTIs) are a commonly treated healthcare condition. When treated in the Emergency Department (ED), empiric antibiotic selection can be challenging due to limited real-time data and the rising prevalence of antimicrobial resistance (AMR), including that of Escherichia coli (E. coli). This study assessed changes in E. coli susceptibility and antimicrobial prescribing for ED-treated community-acquired UTI patients (CA-UTI) over a ten-year period.
METHODS: We conducted a retrospective study of CA-UTI patients (2011 and 2021 cohorts) treated and discharged from a community hospital ED. Adult patients with a positive urine culture (≥100,000 CFU/mL) but without healthcare-associated risk factors were included. Demographics, pathogens, antibiotic susceptibility, and prescribed antibiotics were collected.
RESULTS: One hundred seventy patients from 2011 and 400 patients from 2021 were included. The 2021 cohort was older and had more male patients. E. coli was the predominant pathogen but decreased in proportion among all isolates from 2011 to 2021. Resistance rates for antibiotics remained largely unchanged. Escherichia. coli resistance to levofloxacin (9.2 vs 9.2 %, p = 0.091587) and sulfamethoxazole-trimethoprim (25.2 vs 26.6 %, p = 0.863859) showed minimal change, while nitrofurantoin resistance decreased significantly (8.4 % vs 2.6 %; p = 0.0233). Prescribing patterns shifted, with a decrease in fluoroquinolone (52.3 % vs. 9 %, p ≤ 0.00001)…
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.
Read the paper
Related studies
- Association of lower urinary tract symptoms and OAB severity with quality of life and mental health in China, Taiwan and South Korea: results from a cross-sectional, population-based study
- Ten-Day Quadruple Therapy Comprising Low-Dose Rabeprazole, Bismuth, Amoxicillin, and Tetracycline Is an Effective and Safe First-Line Treatment for Helicobacter pylori Infection in a Population with High Antibiotic Resistance: a Prospective, Multicenter, Randomized, Parallel-Controlled Clinical Trial in China
- The Role of the NLR and PLR in Urinary Tract Infection
- Threat of Antimicrobial Resistance among Pilgrims with Infectious Diseases during Hajj: Lessons Learnt from COVID-19 Pandemic
- Leclercia adecarboxylata urinary tract infection in a patient with bladder cancer and recurrent hematuria
- A Case Series of Staphylococcus lugdunensis Infection in Cancer Patients at an Academic Cancer Institute in the United States
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.