Clinical characteristics and antimicrobial susceptibility pattern of hospitalised patients with community-acquired urinary tract infections at a regional hospital in Taiwan
Luke F. Chen A F , Chun-Ting Chiu B , Jui-Yo Lo C , Si-Yuan Tsai C , Li-Chiu Weng D , Deverick J. Anderson A and Huan-Sheng Chen C EA Program for Infection Prevention and Healthcare Epidemiology, Division of Infectious Diseases and International Health, Department of Medicine, Duke University Medical Center, Durham, NC 27710, USA.
B Medical Clinic at Taoyuan International Airport, Landseed Hospital, Taiwan.
C Center of Infection Control, Landseed Hospital, Taiwan.
D Department of Pathology and Laboratory, Landseed Hospital, Taiwan.
E Division of Infectious Diseases, Department of Internal Medicine, Landseed Hospital, Taiwan.
F Corresponding author. Email: Luke.chen@duke.edu
Healthcare Infection 19(1) 20-25 https://doi.org/10.1071/HI13033
Submitted: 31 August 2013 Accepted: 7 November 2013 Published: 16 December 2013
Abstract
Background: Community-acquired urinary tract infection (UTI) is the most common bacterial infection encountered in hospitals. Effective empirical antibiotic therapy relies on updated epidemiological data.
Aim: We described the epidemiology of patients with urosepsis presenting to a community hospital in Taiwan in order to assess the appropriateness of empirical therapy.
Methods: Retrospective cohort study of hospitalised adult patients with UTI from 1 January to 31 December 2010. The clinical and microbiological characteristics were analysed using descriptive statistics. Logistic regression was performed to determine predictors of antibiotic resistance.
Results: A total of 420 consecutive patients with 599 isolates were identified. Most patients were ≥ 65 years old and women (75.4%), and 114 patients (27.1%) had bacteraemia. Escherichia coli (69%) was the most common organism. Cefazolin was effective against E. coli, K. pneumoniae, and P. mirabilis in greater than 80% of the cases. In male patients, urinary catheter and renal stone were independent predictors for cefazolin resistance; diabetes mellitus and malignancy were predictors among female patients.
Conclusion: Patients admitted with UTI should be screened to identify risk factors for bacteraemia and antimicrobial resistance. The treatment guideline in Taiwan needs to be revised in the current era of increasing antimicrobial resistance.
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