Non-carbapenem therapy of urinary tract infections caused by extended-spectrum ß-lactamase-producing Enterobacteriaceae.
Med Mal Infect
; 45(5): 169-72, 2015 May.
Article
in En
| MEDLINE
| ID: mdl-25845927
ABSTRACT
PURPOSE:
We determined the prevalence of ESBL Enterobacteriaceae in urinary tract infections among inpatients, identified risk factors of acquisition, and evaluated the effectiveness of alternatives to carbapenems.METHODS:
The clinical, microbiological, and therapeutic data as well as the outcomes were recorded for all ESBL-E positive urine samples for three months.RESULTS:
Thirty-one (4%) of the 762 Enterobacteriaceae positive cultures were ESBL producers. The predisposing conditions for being infected with those strains were immunodepression (61%), recent hospitalization (52%), recent antibiotic therapy (52%), and urinary catheterization (61%). 19% of infections were community acquired. The seven cases of acute pyelonephritis and five of prostatitis were treated with piperacillin-tazobactam (5), fluoroquinolones (4), ceftazidime (2), or carbapenems (only 1) after specialized advice. Four (33%) patients relapsed at week 10 three were immunodepressed and three presented with bacteremia.CONCLUSIONS:
Alternatives to carbapenems (especially piperacillin-tazobactam) seem to be a good option for non-bacteremic UTI in immunocompetent patients.Key words
Full text:
1
Collection:
01-internacional
Health context:
3_ND
Database:
MEDLINE
Main subject:
Bacterial Proteins
/
Urinary Tract Infections
/
Beta-Lactamases
/
Beta-Lactam Resistance
/
Enterobacteriaceae
/
Enterobacteriaceae Infections
/
Anti-Bacterial Agents
Type of study:
Etiology_studies
/
Observational_studies
/
Prevalence_studies
/
Prognostic_studies
Language:
En
Journal:
Med Mal Infect
Year:
2015
Document type:
Article