Comparison of community-onset healthcare-associated and hospital-acquired urinary infections caused by extended-spectrum beta-lactamase-producingEscherichia coliand antimicrobial activities

• DOI: 10.1111/ijcp.12608
• Publication Date: 2015-02-16T08:42:12Z
• Authors: N. Saltoglu; R. Karali; M. Yemisen; R. Ozaras; I. I. Balkan; B. Mete; F. Tabak; A. Mert; N. Hondur; R. Ozturk
• Keywords: Nitrofurantoin; Amikacin; Fosfomycin; Trimethoprim; Sulfamethoxazole; Carbapenem

Objective We aimed to compare community-onset healthcare-associated (CO-HCA) and hospital-acquired (HA) urinary tract infections (UTIs) caused by extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli in terms of epidemiology, clinical outcomes antimicrobial activities. Methods Patients from both groups with ESBL-producing E. detected urine culture between January 2009 2011 were included this retrospective study. Relevant demographical, microbiologic data obtained case records. Results A total 173 patients (mean age 58 years, 74% female) included, whom 75 (43.4%) had a CO-HCA UTI 98 (56.6%) an HA UTI. Eighty (46.2%) more than one comorbid disease, 57 (32.5%) urological problems. The most common manifestations pyelonephritis (43.9%) urosepsis (16.2%). An > 65 years (p = 0.005) addition catheterisation 0.001), 0.001) mortality significantly the group. Acute cystitis 0.027), complicated non-urologic neoplasm 0.032) No isolate was resistant carbapenems or fosfomycin. Sensitivities nitrofurantoin, amikacin, trimethoprim sulfamethoxazole-trimoxazole quinolones 97.6%, 89%, 29.4% 17.9% respectively. Both showed similar rates antibiotic resistance. Conclusion should be taken into consideration CO HCA UTI, not only hospital settings but also outpatient settings. suggest ertapenem as first-line empirical treatment for upper fosfomycin nitrofurantoin those lower when is suspected.