Microbiological Features and Clinical Factors Associated with Empirical Antibiotic Resistance in Febrile Patients with Upper Urinary Tract Calculi

Overview

Journal J Korean Med Sci

Specialty General Medicine

Date 2021 Jan 5

PMID 33398940

Citations 3

Authors

Seok Cho

Min Gu Park

Keon Cheol Lee

Sung Yong Cho

Jeong Woo Lee

Affiliations

Soon will be listed here.

Abstract

Background: To investigate the clinical and microbiological features of febrile patients with upper urinary tract calculi and factors that affect empirical antibiotic resistance.

Methods: A retrospective analysis was performed on 203 febrile patients hospitalized between January 2011 and December 2016 with antibiotic treatment for urinary tract infections and upper urinary tract calculi at three institutions. We collected and analyzed data, including patients' age, sex, body mass index, underlying diseases, stone-related factors, and the results of urine and blood culture examinations and antibiotic sensitivity tests.

Results: The male-to-female ratio was 1:2.3. Bacteria were identified in 152 of the 203 patients (74.9%). The most commonly cultured microorganisms included (44.1%), followed by spp. (11.8%), spp. (8.6%), (6.6%), spp. (5.3%), spp. (4.6%), coagulase-negative (4.0%), (4.0%), spp. (2.6%), spp. (0.7%), spp. (0.7%), and mixed infections (7.2%). Cultured bacterial species showed sex-specific differences. Multivariate analysis revealed that calculi's multiplicity was an independent predictive factor for quinolone resistance ( = 0.008). Recurrent infections were a significant predictor of cefotaxime resistance during multivariable analysis ( = 0.041).

Conclusion: Based on the present study results, quinolone was not recommended as the empirical treatment in febrile patients with upper urinary tract calculi. Combination antibiotic therapy is recommended in cases of recurrent infections due to the possible occurrence of cefotaxime resistance.

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References

Tae B, Balpukov U, Cho S, Jeong C . Eleven-year Cumulative Incidence and Estimated Lifetime Prevalence of Urolithiasis in Korea: a National Health Insurance Service-National Sample Cohort Based Study. J Korean Med Sci. 2017; 33(2):e13. PMC: 5729654. DOI: 10.3346/jkms.2018.33.e13. View

Rodriguez-Bano J, Alcala J, Cisneros J, Grill F, Oliver A, Horcajada J . Community infections caused by extended-spectrum beta-lactamase-producing Escherichia coli. Arch Intern Med. 2008; 168(17):1897-902. DOI: 10.1001/archinte.168.17.1897. View

Friedman N, Kaye K, Stout J, McGarry S, Trivette S, Briggs J . Health care--associated bloodstream infections in adults: a reason to change the accepted definition of community-acquired infections. Ann Intern Med. 2002; 137(10):791-7. DOI: 10.7326/0003-4819-137-10-200211190-00007. View

Buehrle D, Shields R, Chen L, Hao B, Press E, Alkrouk A . Evaluation of the In Vitro Activity of Ceftazidime-Avibactam and Ceftolozane-Tazobactam against Meropenem-Resistant Pseudomonas aeruginosa Isolates. Antimicrob Agents Chemother. 2016; 60(5):3227-31. PMC: 4862525. DOI: 10.1128/AAC.02969-15. View

Liu Y, Chen Y, Liao B, Luo D, Wang K, Li H . Epidemiology of urolithiasis in Asia. Asian J Urol. 2018; 5(4):205-214. PMC: 6197415. DOI: 10.1016/j.ajur.2018.08.007. View

Patton J, Nash D, Abrutyn E . Urinary tract infection: economic considerations. Med Clin North Am. 1991; 75(2):495-513. DOI: 10.1016/s0025-7125(16)30466-7. View

Foxman B . Epidemiology of urinary tract infections: incidence, morbidity, and economic costs. Am J Med. 2002; 113 Suppl 1A:5S-13S. DOI: 10.1016/s0002-9343(02)01054-9. View

Pfaller M, Bassetti M, Duncan L, Castanheira M . Ceftolozane/tazobactam activity against drug-resistant Enterobacteriaceae and Pseudomonas aeruginosa causing urinary tract and intraabdominal infections in Europe: report from an antimicrobial surveillance programme (2012-15). J Antimicrob Chemother. 2017; 72(5):1386-1395. DOI: 10.1093/jac/dkx009. View

Bouchillon S, Badal R, Hoban D, Hawser S . Antimicrobial susceptibility of inpatient urinary tract isolates of gram-negative bacilli in the United States: results from the study for monitoring antimicrobial resistance trends (SMART) program: 2009-2011. Clin Ther. 2013; 35(6):872-7. DOI: 10.1016/j.clinthera.2013.03.022. View

10.

Marien T, Mass A, Shah O . Antimicrobial resistance patterns in cases of obstructive pyelonephritis secondary to stones. Urology. 2014; 85(1):64-8. DOI: 10.1016/j.urology.2014.10.007. View

11.

Levey A, de Jong P, Coresh J, El Nahas M, Astor B, Matsushita K . The definition, classification, and prognosis of chronic kidney disease: a KDIGO Controversies Conference report. Kidney Int. 2010; 80(1):17-28. DOI: 10.1038/ki.2010.483. View

12.

Pricop C, Dorobat C, Puia D, Orsolya M . Antibiotic prophylaxis in retrograde ureteroscopy: what strategy should we adopt?. Germs. 2014; 3(4):115-21. PMC: 3882851. DOI: 10.11599/germs.2013.1045. View

13.

Kittanamongkolchai W, Vaughan L, Enders F, Dhondup T, Mehta R, Krambeck A . The Changing Incidence and Presentation of Urinary Stones Over 3 Decades. Mayo Clin Proc. 2018; 93(3):291-299. PMC: 5849397. DOI: 10.1016/j.mayocp.2017.11.018. View

14.

Edvardsson V, Indridason O, Haraldsson G, Kjartansson O, Palsson R . Temporal trends in the incidence of kidney stone disease. Kidney Int. 2012; 83(1):146-52. DOI: 10.1038/ki.2012.320. View

15.

Azap O, Arslan H, Serefhanoglu K, Colakoglu S, Erdogan H, Timurkaynak F . Risk factors for extended-spectrum beta-lactamase positivity in uropathogenic Escherichia coli isolated from community-acquired urinary tract infections. Clin Microbiol Infect. 2009; 16(2):147-51. DOI: 10.1111/j.1469-0691.2009.02941.x. View

16.

Beeson P, Guze L . Experimental pyelonephritis. I. Effect of ureteral ligation on the course of bacterial infection in the kidney of the rat. J Exp Med. 1956; 104(6):803-15. PMC: 2136652. DOI: 10.1084/jem.104.6.803. View

17.

Buonaiuto V, Marquez I, De Toro I, Joya C, Ruiz-Mesa J, Seara R . Clinical and epidemiological features and prognosis of complicated pyelonephritis: a prospective observational single hospital-based study. BMC Infect Dis. 2014; 14:639. PMC: 4267459. DOI: 10.1186/s12879-014-0639-4. View

18.

Gupta K, Hooton T, Naber K, Wullt B, Colgan R, Miller L . International clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women: A 2010 update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases. Clin Infect Dis. 2011; 52(5):e103-20. DOI: 10.1093/cid/ciq257. View

19.

KENNEDY R, PLORDE J, Petersdorf R . STUDIES ON THE EPIDEMIOLOGY OF ESCHERICHIA COLI INFECTIONS. IV. EVIDENCE FOR A NOSOCOMIAL FLORA. J Clin Invest. 1965; 44:193-201. PMC: 292468. DOI: 10.1172/JCI105134. View

20.

Aguilar-Duran S, Horcajada J, Sorli L, Montero M, Salvado M, Grau S . Community-onset healthcare-related urinary tract infections: comparison with community and hospital-acquired urinary tract infections. J Infect. 2012; 64(5):478-83. DOI: 10.1016/j.jinf.2012.01.010. View