Bacteraemic urinary tract infections in a tertiary hospital in Japan: the epidemiology of community-acquired infections and the role of non-carbapenem therapyReport as inadecuate




Bacteraemic urinary tract infections in a tertiary hospital in Japan: the epidemiology of community-acquired infections and the role of non-carbapenem therapy - Download this document for free, or read online. Document in PDF available to download.

BMC Research Notes

, 10:336

First Online: 27 July 2017Received: 04 February 2017Accepted: 22 July 2017

Abstract

ObjectivesThis study aimed to describe the epidemiology of bacteraemic urinary tract infections UTIs, especially those that were community-acquired i.e., with no discernible healthcare-associated exposure and caused by extended-spectrum beta-lactamase-producing Enterobacteriaceae ESBLPE. We also evaluated and compared empirical antimicrobial treatments carbapenem CBP vs. non-carbapenem beta-lactam non-CBPBL for bacteraemic UTIs. Finally, we reviewed the published literature on the effectiveness of non-CBP compared to CBP treatments for UTIs caused by extended-spectrum beta-lactamase-producing organisms.

ResultsA total of 339 bacteraemic UTI episodes were identified; 32 9.4% were caused by ESBLPE. In bacteraemic UTI episodes, ESBLPE accounted for 8.3% of hospital-acquired cases, 10.0% of community-acquired cases, and 8.2% of non-healthcare-associated cases. As effective empirical therapy for ESBLPE, 12 patients received CBP and 7 patients received non-CBPBL treatments piperacillin-tazobactam PT or cefmetazole CMZ. Age, sex, Pitt bacteraemia score, immunosuppressive status, and causative bacterial species were similar between groups; neither group experienced mortality within 14 days. The number of days to defervescence was similar between groups. No difference was noted in the rates of microbiological cure 58% vs. 57%, P = 1.0. Five of seven patients in the non-CBPBL group did not receive CBP during the treatment period, even as definitive therapy, but all experienced clinical cure.

KeywordsESBL-producing Enterobacteriaceae Urinary tract infection Non-carbapenem β-lactam Community AbbreviationsBLBLIbeta-lactam-beta-lactamase inhibitor

CAcommunity-acquired

CBPcarbapenem

CLSIClinical and Laboratory Standards Institute

CMZcefmetazole

ESBLextended-spectrum beta-lactamase

ESBLPEextended-spectrum beta-lactamase-producing Enterobacteriaceae

HAhospital-acquired

JANISJapan Nosocomial Infections Surveillance

Non-CBPBLnon-carbapenem beta-lactam

UTIurinary tract infection

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Author: Momoko Mawatari - Kayoko Hayakawa - Yoshihiro Fujiya - Kei Yamamoto - Satoshi Kutsuna - Nozomi Takeshita - Norio Ohmagari

Source: https://link.springer.com/







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