Objectives: We aimed to determine the most common bac teria that cause urinary tract infections (UTIs), the rate of an tibiotic resistance of these uropathogens, and the changes in resistance rates over the years for adult patients diag nosed with UTIs. Methods: We retrospectively reviewed urine cultures and antibiotic susceptibility results of patients > 17 years of age from our outpatient clinic between 2014 and 2018. The most common uropathogens and their anti biotic resistance rates were identified in different age groups (18-39, 40-59, and ≥60 years) and with respect to gender and date of admission. In addition, the change in antibiotic resistance of Escherichia coli between 2014 and 2018 was also examined. Results: A total of 9,556 positive urine cul tures were included. The most common uropathogen was E. coli, and its prevalence was higher in females than males (70.6 vs. 53.4%, respectively). The majority of isolates were from patients ≥60 years of age. E. coli resistance was most pronounced for ampicillin (61.56%), followed by trimeth oprimsulfamethoxazole (49.80%), amoxicillinclavulanic acid (34.69%), and cefazolin (30.72%). E. coli resistance to am picillin, nitrofurantoin, cefepime, ciprofloxacin, fosfomycin, and amoxicillinclavulanic acid increased significantly with time (all p = 0.001). For E. coli, resistance to ciprofloxacin, one of the most commonly used antibiotics for UTI, increased from 17 to 43% from 2014 to 2018. Conclusion: Most of the uropathogens displayed high resistance to ampicillin, tri methoprimsulfamethoxazole, and amoxicillinclavulanic acid, and were susceptible to meropenem, ertapenem, and imipenem. Fosfomycin and cefepime were useful in the em pirical treatment of communityacquired UTIs. A surprisingly high increase was observed in the resistance of E. coli to an timicrobial agents from 2014 to 2018.
Purpose
To evaluate the impact of delay in cystoscopic surveillance on recurrence and progression rates in non‐muscle‐invasive bladder cancer (NMIBC).
Materials and methods
A total of 407 patients from four high‐volume centres with NMIBC that applied for follow‐up cystoscopy were included in our study prospectively. Patients’ demographics and previous tumour characteristics, the presence of tumour in follow‐up cystoscopy, the pathology results of the latest transurethral resection of bladder tumour (if tumour was detected) and the delay in cystoscopy time were recorded. Our primary outcomes were tumour recurrences detected by follow‐up cystoscopy and progression. Multivariate logistic regression analysis was performed using the possible factors identified with univariate analyses (P values ≤ .2).
Results
A total of 105 patients (25.8%) had tumour recurrence in follow‐up cystoscopy, and 20 (5.1%) of these patients had disease progression according to grade or stage. In multivariate analysis, the number of recurrences (OR: 1.307, P < .001) and the cystoscopy delay time (62‐147 days, OR: 2.424, P = .002; >147 days, OR: 4.883, P < .001) were significant risk factors for tumour recurrence on follow‐up cystoscopy; the number of recurrences (OR: 1.255, P = .024) and cystoscopy delay time (>90 days, OR: 6.704, P = .002) were significant risk factors for tumour progression.
Conclusions
This study showed that a 2‐5 months of delay in follow‐up cystoscopy increases the risk of recurrence by 2.4‐fold, and delay in cystoscopy for more than 3 months increases the probability of progression by 6.7‐fold. We suggest that cystoscopic surveillance should be done during the COVID‐19 pandemic according to the schedule set by relevant guidelines.
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