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Resistance ofEscherichia coliurinary isolates in ED-treated patients from a community hospital
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Resistance ofEscherichia coliurinary isolates in ED-treated patients from a community hospital
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Resistance ofEscherichia coliurinary isolates in ED-treated patients from a community hospital
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Journal Article
Resistance ofEscherichia coliurinary isolates in ED-treated patients from a community hospital
2014
Overview
Purpose The purpose of this study is to provide resistance data forEscherichia coliisolates causing urinary tract infections in emergency department (ED) patients not requiring admission and explore if differences between this subpopulation and the hospital antibiogram exist. Differences between community-acquired urinary tract infection (CA-UTI) and health care-associated (HA-UTI) subgroups were also investigated. Methods Patients with a positive urine culture treated and discharged from the ED of a 200-bed community hospital were reviewed. Patients with urinary isolates of more than 100000 colony-forming unit/mL and documented intention to treat were included. Patients who required admission, were pregnant, less than the age of 18 years, or who had a positive culture but without any evidence of intention to treat were excluded. Only the initial visit was included for patients who returned to the ED within 7 days. Results Overall, 308 visits were screened, and 217 were included. Of these, 78.3% were CA-UTI, and 21.7% were HA-UTI. Females comprised 88.5% of all patients.E coliwas the most common pathogen overall and in both subgroups.E coliresistance to levofloxacin was 13.5% overall, 9.2% for CA-UTI, and 38.5% for HA-UTI compared with 27% on the hospital antibiogram.E coliresistance to sulfamethoxazole/trimethoprim was 26.9% overall, 25.2% for CA-UTI, and 34.6% for HA-UTI vs 26% on the antibiogram. Conclusions E colisusceptibility for ED patients not requiring admission may not be accurately represented by hospital antibiograms that contain culture data from various patient types, sites of infection, or patients with varying illness severity. Separation of the ED population into CA-UTI and HA-UTI subgroups may be helpful when selecting empiric antibiotic therapy.
Publisher
Elsevier Limited
