Antimicrobial Susceptibility and Cross-Resistance Patterns among Common Complicated Urinary Tract Infections in U.S. Hospitals, 2013 to 2018
Copyright © 2020 American Society for Microbiology..
In the face of increasing rates of antimicrobial resistance in complicated urinary tract infections (cUTIs), clinicians need to understand cross-resistance patterns among commonly encountered pathogens. We performed a multicenter, retrospective cohort study in the Premier database of approximately 180 hospitals, from 2013 to 2018. Using an ICD-9/10-based algorithm, we identified all adult patients hospitalized with cUTIs and included those with a positive blood or urine culture. We examined the microbiology and susceptibilities to common cUTI antimicrobials (3rd-generation cephalosporin [C3], fluoroquinolones [FQ], trimethoprim-sulfamethoxazole [TMP/SMZ], fosfomycin [FFM], and nitrofurantoin [NFT]) singly and in groups of two. Among 28,057 organisms from 23,331 patients, the 3 most common pathogens were Escherichia coli (41.0%; C3r, 15.1%), Klebsiella pneumoniae (12.1%; C3r, 13.2%), and Pseudomonas aeruginosa (11.0%; C3r, 12.0%). E. coli was most frequently resistant to FQ (43.5%) and least to NFT (6.7%). K. pneumoniae was most frequently resistant to NFT (60.8%) and least to FFM (0.1%). P. aeruginosa was most frequently resistant to FQ (34.4%) and least to TMP/SMZ (4.2%). Of the C3rE. coli isolates, 87.1% were also FQr, 63.7% were TMP/SMZr, and 13.3% were NFTr C3rK. pneumoniae isolates had a 76.5% chance of being FQr, 78.1% were TMP/SMZr, and 77.6% were NFTr C3rP. aeruginosa coexisted with FQr in 47.3%, TMP/SMZr in 18.9%, and NFTr in 28.7%. Among the most common pathogens isolated from hospitalized patients with cUTIs, the rates of single resistance to common treatments and of cross-resistance to these regimens are substantial. Knowing the patterns of cross-resistance may help clinicians tailor empirical therapy more precisely.
| Errataetall: |
CommentIn: Antimicrob Agents Chemother. 2020 Dec 16;65(1):. - PMID 33139272 |
|---|---|
| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2020 |
|---|---|
| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:64 |
|---|---|
| Enthalten in: |
Antimicrobial agents and chemotherapy - 64(2020), 8 vom: 22. Juli |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Zilberberg, Marya D [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Anti-Bacterial Agents |
|---|
| Anmerkungen: |
Date Completed 17.06.2021 Date Revised 17.06.2021 published: Electronic-Print CommentIn: Antimicrob Agents Chemother. 2020 Dec 16;65(1):. - PMID 33139272 Citation Status MEDLINE |
|---|
| doi: |
10.1128/AAC.00346-20 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM310065496 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM310065496 | ||
| 003 | DE-627 | ||
| 005 | 20231225135302.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2020 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1128/AAC.00346-20 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1033.xml |
| 035 | |a (DE-627)NLM310065496 | ||
| 035 | |a (NLM)32423953 | ||
| 035 | |a (PII)e00346-20 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Zilberberg, Marya D |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Antimicrobial Susceptibility and Cross-Resistance Patterns among Common Complicated Urinary Tract Infections in U.S. Hospitals, 2013 to 2018 |
| 264 | 1 | |c 2020 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 17.06.2021 | ||
| 500 | |a Date Revised 17.06.2021 | ||
| 500 | |a published: Electronic-Print | ||
| 500 | |a CommentIn: Antimicrob Agents Chemother. 2020 Dec 16;65(1):. - PMID 33139272 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2020 American Society for Microbiology. | ||
| 520 | |a In the face of increasing rates of antimicrobial resistance in complicated urinary tract infections (cUTIs), clinicians need to understand cross-resistance patterns among commonly encountered pathogens. We performed a multicenter, retrospective cohort study in the Premier database of approximately 180 hospitals, from 2013 to 2018. Using an ICD-9/10-based algorithm, we identified all adult patients hospitalized with cUTIs and included those with a positive blood or urine culture. We examined the microbiology and susceptibilities to common cUTI antimicrobials (3rd-generation cephalosporin [C3], fluoroquinolones [FQ], trimethoprim-sulfamethoxazole [TMP/SMZ], fosfomycin [FFM], and nitrofurantoin [NFT]) singly and in groups of two. Among 28,057 organisms from 23,331 patients, the 3 most common pathogens were Escherichia coli (41.0%; C3r, 15.1%), Klebsiella pneumoniae (12.1%; C3r, 13.2%), and Pseudomonas aeruginosa (11.0%; C3r, 12.0%). E. coli was most frequently resistant to FQ (43.5%) and least to NFT (6.7%). K. pneumoniae was most frequently resistant to NFT (60.8%) and least to FFM (0.1%). P. aeruginosa was most frequently resistant to FQ (34.4%) and least to TMP/SMZ (4.2%). Of the C3rE. coli isolates, 87.1% were also FQr, 63.7% were TMP/SMZr, and 13.3% were NFTr C3rK. pneumoniae isolates had a 76.5% chance of being FQr, 78.1% were TMP/SMZr, and 77.6% were NFTr C3rP. aeruginosa coexisted with FQr in 47.3%, TMP/SMZr in 18.9%, and NFTr in 28.7%. Among the most common pathogens isolated from hospitalized patients with cUTIs, the rates of single resistance to common treatments and of cross-resistance to these regimens are substantial. Knowing the patterns of cross-resistance may help clinicians tailor empirical therapy more precisely | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a antimicrobial resistance | |
| 650 | 4 | |a complicated UTI | |
| 650 | 4 | |a cross-resistance | |
| 650 | 4 | |a hospitalization | |
| 650 | 7 | |a Anti-Bacterial Agents |2 NLM | |
| 650 | 7 | |a Anti-Infective Agents |2 NLM | |
| 700 | 1 | |a Nathanson, Brian H |e verfasserin |4 aut | |
| 700 | 1 | |a Sulham, Kate |e verfasserin |4 aut | |
| 700 | 1 | |a Shorr, Andrew F |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Antimicrobial agents and chemotherapy |d 1972 |g 64(2020), 8 vom: 22. Juli |w (DE-627)NLM000026506 |x 1098-6596 |7 nnns |
| 773 | 1 | 8 | |g volume:64 |g year:2020 |g number:8 |g day:22 |g month:07 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1128/AAC.00346-20 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 64 |j 2020 |e 8 |b 22 |c 07 | ||