Extended-Spectrum Beta-Lactamase Production by Enterobacteriaceae Isolates From Urine Cultures of Outpatients: Results of a 7-Year Follow-Up

Çelikbilek, Nevreste; Gözalan, Ayşegül; Özdem, Birsen; Kırca, Fisun; Açıkgöz, Ziya Cibali

doi:10.5578/mb.9031

Cited by 8 publications

(7 citation statements)

References 13 publications

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“…[4,5,16] Based on the 2013 data released by National Antimicrobial Resistance Surveillance System (UAMDS) in Turkey, ESBL-producing strains were detected in 44.9% of E. coli, and 49.9% of K. pneumoniae isolates. In our study the most frequent microbial agent was E. coli (63.1%).…”

Section: Discussionmentioning

confidence: 99%

“…Resistance rates against quinolone antibiotics are gradually increasing among Gram-negative urinary pathogens. [16] Based on 2013 UAMDS data rates of resistance against ciprofloxacin among E.coli and K. pneumoniae isolates were 44.0, and 43.0%, respectively. Similarly, in our study 40%, and 44.6% of all Gram-negative agents were resistant to ciprofloxacin, and cotrimoxazole, respectively.…”

Section: Discussionmentioning

confidence: 99%

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Clinical effect of discordance in empirical treatment of cases with urinary tract infection accompanied by bacteremia

Dökmetaş¹,

Hamidi²,

Bulut³

et al. 2017

Turkish Journal of Urology

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Objective: It has been shown in previous studies that inadequate empirical treatment is associated with mortality in a variety of infections caused by Gram-negative bacteria. In this study, the clinical effect of discordance in empirical treatment was investigated in patients with urinary tract infection (UTI) accompanied by bacteremia. Material and methods:We retrospectively reviewed the files of adult (>18 years old) patients who were diagnosed with UTI in our clinic between January 2014 and December 2015. Cases in which the same causative microorganism grew in both blood and urine cultures were included in the study. Patients using ceftriaxone and carbapenem as empirical antibiotic therapy (EAT) were compared as two different groups. In cases that the ethiologic agents were extended-spectrum beta lactamase (ESBL)-producing Klebsiella pneumoniae and Escherichia coli isolates, if the microorganism was resistant to initial antibiotic treatment the situation was defined as EAT discordance, and if it was sensitive it was defined as EAT concordance. Results:After the exclusion criteria were applied, 65 of the 266 cases examined were taken into the study. Clinical and laboratory features of cases of ceftriaxone and carbapenem groups were similar. There was no statistically significant difference between the two groups in terms of hospital stay and survival (p>0.05). Of 28 cases of ESBL-producing E. coli and K. pneumoniae, 18 were EAT discordant and 10 were EAT concordant. Clinical and laboratory features of EAT concordant and EAT discordant groups were similar. No statistically significant difference was found between the two groups in terms of hospital stay and survival (p>0.05). Conclusion:It was considered that ceftriaxone can still be a viable option in the EAT of UTI, which is accompanied by bacteremia without severe sepsis and septic shock findings. It was concluded that EAT discordance may not have a negative effect on the duration of hospital stay and survival rates in neither total cases nor ESBL positive ones.Keywords: Bacteremia; empirical antibiotic therapy; urinary tract infection.Cite this article as: Dökmetaş İ, Hamidi AA, Bulut ME, Çetin S, Öncül A, Uzun N. Clinical effect of discordance in empirical treatment of cases with urinary tract infection accompanied by bacteremia. Turk J Urol 2017; 43(4): 543-8.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Clinical effect of discordance in empirical treatment of cases with urinary tract infection accompanied by bacteremia

Dökmetaş¹,

Hamidi²,

Bulut³

et al. 2017

Turkish Journal of Urology

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“…A study conducted in Ankara monitored ESBL positivity rates in Enterobacteriaceae strains isolated from 12,535 urine cultures from outpatients treated between 2007-2013 and revealed a total ESBL positivity rate of 21.8% [28] .…”

Section: Public Interventionsmentioning

confidence: 99%

“…When antibacterial cultures and prescriptions were evaluated after emergency visits, approximately 50% of the antibiotic prescriptions were corrected/adjusted [32] . In Turkey, the number of emergency department visits is about three times greater and the percentage of antibiotic prescriptions is several times higher [26,28,33] .…”

Section: Program Outcomesmentioning

confidence: 99%

Antibiotic Consumption, Resistance Data, and Prevention Strategies

Karabay¹,

Baştuğ²,

Öztürk³

et al. 2020

mjima

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“…Extended-spectrum beta lactamase (ESBL)-producing urinary pathogens are steadily increasing in Turkey, [1][2][3][4][5][6] which usually require IV carbapenems because oral antibiotic options are limited. However, this increases the hospitalization rate, related costs, 7 and the risk of hospital-acquired infections including SARS-CoV-2.…”

Section: Introductionmentioning

confidence: 99%

Daily inpatient ertapenem therapy can be an alternative to hospitalization for the treatment of complicated urinary tract infections during the COVID‐19 pandemic

et al. 2021

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Background: Physicians hospitalize the patients with complicated urinary tract infections (cUTIs) when they need intravenous antibiotics and outpatient parenteral antimicrobial therapy (OPAT) is unavailable. Daily inpatient antimicrobial therapy is an alternative to hospitalization, which is similar to OPAT; patients go home after they are administered antibiotics in a separate room in the hospital setting.Objectives: We assessed our previous daily inpatient practice to revitalize the model in the COVID-19 era. Materials and Methods:We retrospectively evaluated the clinical and microbiological responses and the cost effectiveness of the patients with cUTIs who received daily inpatient ertapenem therapy. Results:Our study population was 136 patients in 156 episodes. It was a difficultto-treat group with older age (mean 63.0 ± 14.8 years) and a high burden of underlying conditions (86.5%). The most common causative organisms were Escherichia coli (74.4%) and Klebsiella pneumoniae (19.2%); 89.7% of the isolates were producing extended-spectrum beta lactamase (ESBL). The microbiologic and clinical success rates were 82.1% and 95.5%, respectively. The patients required hospitalization in 16 episodes (10.2%) because of clinical failures (3.8%), superinfections (2%), planned invasive interventions (3.2%), and side effects (1.2%). Our university hospital saved 1608 bed-days and 2596 € (9702 TL) bed costs. Conclusions:In the COVID-19 pandemic period, this seems to be an effective, safe, and cost-effective way to decrease hospitalizations for cUTIs in settings where OPAT is unavailable. What's known• Antimicrobial resistance in the complicated urinary tract infections is a global challenge for optimal antimicrobial treatment.• Hospitalization of these patients has increased the cost, risk of transmissions of COVID-19, and infections.• Ertapenem is suitable for outpatient parenteral antimicrobial therapy (OPAT).How to cite this article: Nazli Zeka A, Avkan-Oguz V, Irmak C, et al. Daily inpatient ertapenem therapy can be an alternative to hospitalization for the treatment of complicated urinary tract infections during the COVID-19 pandemic. Int J Clin Pract.

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Extended-Spectrum Beta-Lactamase Production by Enterobacteriaceae Isolates From Urine Cultures of Outpatients: Results of a 7-Year Follow-Up

Cited by 8 publications

References 13 publications

Clinical effect of discordance in empirical treatment of cases with urinary tract infection accompanied by bacteremia

Clinical effect of discordance in empirical treatment of cases with urinary tract infection accompanied by bacteremia

Antibiotic Consumption, Resistance Data, and Prevention Strategies

Daily inpatient ertapenem therapy can be an alternative to hospitalization for the treatment of complicated urinary tract infections during the COVID‐19 pandemic

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