Dataset Information

Treatment duration of complicated urinary tract infections by extended-spectrum beta-lactamases producing enterobacterales.

ABSTRACT: BACKGROUND:Urinary tract infections caused by extended-spectrum beta-lactamase producing Enterobacterales (ESBL-EB) are a problem increasing in our clinical practice. OBJECTIVES:The aim of this study was to evaluate the clinical outcome in patients who received short (? 7 days) versus long courses (>7 days) of antimicrobial therapy for complicated ESBL-EB urinary tract infections. METHODS:This is a retrospective and observational study. Positive urine cultures for ESBL-EB in our hospital between March 2015 and July 2017 were identified. Patients with complicated urinary tract infection were included. Differences between treatment groups (7 days or less vs more than 7 days) were analyzed according to baseline characteristics and severity of clinical presentation. Primary outcome was all cause 30-day mortality. Secondary outcome was a combined item of all cause mortality and reinfection by the same enterobacteria at 30 days. RESULTS:273 urine cultures were positive for ESBL-EB during the study period. 75 episodes were included, 40 in the long treatment group and 35 in the short treatment group. Mean treatment duration in short and long treatment groups was 6,1 and 13,8 days respectively. Mortality at 30 days was 5,7% in the short treatment group and 5% in the long treatment group without significant differences (P = 0,8). Mortality or reinfection by the same ESBL-EB at 30 days was 8,6% in the short treatment group and 10% in the long treatment group, without significant differences (P = 0,8). CONCLUSIONS:Short courses of antimicrobial treatment seems to be effective as treatment of complicated urinary tract infections by ESBL-EB.

SUBMITTER: Alvarez Otero J

PROVIDER: S-EPMC7571686 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Treatment duration of complicated urinary tract infections by extended-spectrum beta-lactamases producing enterobacterales.

Álvarez Otero Judith J Lamas Ferreiro Jose Luis JL Sanjurjo Rivo Ana A Maroto Piñeiro Fernando F González González Lucía L Enríquez de Salamanca Holzinger Ignacio I Cavero Jorge J Rodríguez Conde Irene I Fernández Soneira María M de la Fuente Aguado Javier J

PloS one 20201019 10

<h4>Background</h4>Urinary tract infections caused by extended-spectrum beta-lactamase producing Enterobacterales (ESBL-EB) are a problem increasing in our clinical practice.<h4>Objectives</h4>The aim of this study was to evaluate the clinical outcome in patients who received short (≤ 7 days) versus long courses (>7 days) of antimicrobial therapy for complicated ESBL-EB urinary tract infections.<h4>Methods</h4>This is a retrospective and observational study. Positive urine cultures for ESBL-EB i ...[more]

PMID: 33075076

Similar Datasets

Project description:IntroductionMultidrug resistance (MDR) and emergence of extended-spectrum β-lactamases (ESBLs) that mediate resistance to β-lactam drugs among Escherichia coli and other uropathogens have been reported worldwide. However, there is little information on the detection of ESBLs genes in E. coli from patients with urinary tract infections (UTIs) in the Arab countries using polymerase chain reaction (PCR), and in Libya such information is lacking.MethodsAll patients attending Zawiya Teaching Hospital in Zawiya city between November 2012 and June 2013 suspected of having UTIs and from whom midstream urine samples were taken as part of the clinical workup were included in this prospective study. Samples were examined for uropathogens by standard bacteriological procedures. VITEK-2 automated microbiology system was used to identify the isolated uropathogens and determine the susceptibility of E. coli and Klebsiella spp. isolates to antimicrobials. In addition, phenotypically ESBLs-positive E. coli isolates were tested for ESBLs genes by PCR.ResultsThe present study enrolled 1,790 patients with UTIs. Uropathogens were found in 371 (20.7%) urine specimens examined. Mixed pathogens were detected in two specimens with 373 total pathogens isolated. E. coli and Klebsiella spp. were the predominant uropathogens at 55.8% (208/373) and 18.5% (69/373), respectively. Other pathogens were detected in 25.7% (96/373) of urine samples. Of the E. coli and Klebsiella spp. tested, 69.2 and 100% were resistant to ampicillin, 6.7 and 33.3% to ceftriaxone, and 23.1 and 17.4% to ciprofloxacin, respectively. MDR (resistance to ≥3 antimicrobial groups) was found in 69 (33.2%) of E. coli and in 29 (42%) of Klebsiella spp. isolates. ESBLs were detected phenotypically in 14 (6.7%) of E. coli and in 15 (21.7%) of Klebsiella spp. isolates. Thirteen out of the 14 phenotypically ESBL-positive E. coli were positive for ESBL genes by PCR. bla TEM gene was detected in seven isolates, bla OXA gene in 10 isolates and bla CTX-M gene in six isolates. bla SHV gene was not detected in the present study.ConclusionThe isolation of MDR ESBL-producing uropathogens undoubtedly will limit the choices clinicians have to treat their patients with UTIs. Therefore, there is an urgent need for surveillance studies on antimicrobial resistance and prevalence of ESBLs among uropathogens to guide the clinical treatment of UTIs in Libya in the future.

Dataset Information

Treatment duration of complicated urinary tract infections by extended-spectrum beta-lactamases producing enterobacterales.

Publications

Treatment duration of complicated urinary tract infections by extended-spectrum beta-lactamases producing enterobacterales.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets