Impact of Extended-Spectrum β-Lactamase Production on Treatment Outcomes of Acute Pyelonephritis Caused by Escherichia coli in Patients without Health Care-Associated Risk Factors

Choi, Su‐Mi; Lee, Dong Gun; Cho, Sung‐Yeon; Choi, Jae-Ki; Choi, Jung Hyun; Yoo, Jin‐Hong

doi:10.1128/aac.04821-14

Cited by 26 publications

(25 citation statements)

References 31 publications

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“…In our series, 97% of patients were cured, just like Qureshi et al13 and Chapman et al16 reported in their series. In other series, the readmission of patients reported was around 6.3% over a period of 2 years; however, in our series only 3% of the patients required readmission.…”

Section: Discussionsupporting

confidence: 84%

Outpatient ertapenem therapy in an ESBL-high-prevalence area: an efficacy, safety, and cost study

Ortiz-Álvarez

Delgado-Ramírez

et al. 2018

IDR

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IntroductionOutpatient parenteral antimicrobial therapy is a safe, effective, and convenient way of administering antimicrobials for a wide variety of infections. So far there are no reports on the efficacy of outpatient antimicrobial therapy in Mexico. Our objective was to determine the outcomes, safety, and cost of outpatient ertapenem therapy (OET) in our hospital.Patients and methodsA case series of 99 patients that received intravenous OET was conducted. The primary outcomes were clinical cure, relapse, and recurrence of infection.ResultsOf the 99 patients who received OET the most common diagnosis was urinary tract infection in 56%. Extended-spectrum-β-lactamase-producing Enterobacteriaceae caused 67% of infections in our population. Ninety-seven percent of the patients were cured at the completion of OET. One patient presented relapse 12 days after the end of OET; two patients presented recurrence, one with skin and soft tissue infection and one with pyelonephritis at days 35 and 34, respectively, after the end of OET. Three patients were readmitted after OET, one with an episode of phlebitis, one with recurrence, and one with relapse. A case of non-Clostridium difficile-associated diarrhea was observed. The intravascular line complications observed during OET were phlebitis in two patients.ConclusionIn our hospital, the OET was found to be effective, safe, and cost-saving when compared to inpatient care.

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Section: Discussionsupporting

confidence: 84%

Outpatient ertapenem therapy in an ESBL-high-prevalence area: an efficacy, safety, and cost study

Ortiz-Álvarez

Delgado-Ramírez

et al. 2018

IDR

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“…Age over 55 years (OR: 2.0, 95% CI: 1.0–3.5) 30 and male sex (OR: 1.6, 95% CI: 1.2–2.1 in the higher quality study by Søgaard et al) 38 also have been reported as risk factors for UTI due to ESBL-producing E. coli .…”

Section: Resultsmentioning

confidence: 99%

<p>Risk Factors of Extended-Spectrum Beta-Lactamases-Producing <em>Escherichia coli</em> Community Acquired Urinary Tract Infections: A Systematic Review</p>

Larramendy¹,

Deglaire²,

Dusollier³

et al. 2020

IDR

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Purpose The prevalence of extended-spectrum beta-lactamase-producing Escherichia coli (ESBL-EC) has been increasing worldwide since the early 2000s. E. coli is found in 70–90% of community-acquired urinary tract infections (CA-UTIs). We performed a systematic literature review to determine the risk factors for CA-UTI caused by ESBL-EC. Methods We searched the MEDLINE, Cochrane Library, Embase and Web of Science databases without language or date restriction up to March 2019. Two independent reviewers selected studies with quantified risk factors for CA-UTI due to ESBL-EC, and assessed their quality using the Newcastle-Ottawa Scale. Results Among the 5,597 studies identified, 16 observational studies (n=12,138 patients) met the eligibility criteria. The included studies were performed in various countries, and 14/16 were published after 2012. The most relevant risk factors for CA-UTI due to ESBL-EC identified were prior use of antibiotics (odds ratio (OR) from 2.2 to 21.4), previous hospitalization (OR: 1.7 to 3.9), and UTI history (OR: 1.3 to 3.8). Two risk factors were related to environmental contamination: travelling abroad, and swimming in freshwater. Conclusion Our findings could allow adapting empiric antibiotic treatments according to the patient profile. Further studies are needed to quantify the relationships between CA-UTI due to ESBL-EC and the environment.

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“…Studies #7 and #10 had fewer than 25% of UTIs among the total infections in the group. CBP was not significantly superior to non-CBP agents in the studies that included 40% or more of UTIs among the total infections (studies #4–6 [ 4 , 12 , 13 ], #8 [ 14 ], #9 [ 15 ], #11 [ 16 ]).…”

Section: Main Textmentioning

confidence: 99%

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

et al. 2017

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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.

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Impact of Extended-Spectrum β-Lactamase Production on Treatment Outcomes of Acute Pyelonephritis Caused by Escherichia coli in Patients without Health Care-Associated Risk Factors

Cited by 26 publications

References 31 publications

Outpatient ertapenem therapy in an ESBL-high-prevalence area: an efficacy, safety, and cost study

Outpatient ertapenem therapy in an ESBL-high-prevalence area: an efficacy, safety, and cost study

<p>Risk Factors of Extended-Spectrum Beta-Lactamases-Producing <em>Escherichia coli</em> Community Acquired Urinary Tract Infections: A Systematic Review</p>

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

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