Management of complicated urinary tract infections in a referral center in Mexico

Cornejo-Dávila, V.; Palmeros-Rodríguez, M.A.; Meneses, I. Uberetagoyena-Tello de; Mayorga-Gómez, E.; Garza-Sáinz, G.; Osornio-Sánchez, V.; Trujillo-Ortíz, L.; Sedano-Basilio, Jorge E.; Cantellano-Orozco, M.; Martínez-Arroyo, C.; Morales-Montor, J.G.; Pacheco-Gahbler, Carlos

doi:10.1007/s11255-014-0883-y

Cited by 7 publications

(4 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The prevalence of drug-resistant microorganisms is growing worldwide,1 and in our hospital ESBL-producing Escherichia coli (ESBL-EC) causes 71.4% of acute pyelonephritis episodes 2. Ertapenem is an exceptional antibiotic given as once-daily dosing, and its broad spectrum of activity makes it suitable for outpatient antimicrobial therapy (OPAT) 3.…”

Section: Introductionmentioning

confidence: 99%

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

Ortiz-Álvarez

Delgado-Ramírez

et al. 2018

IDR

View full text Add to dashboard Cite

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.

show abstract

Section: Introductionmentioning

confidence: 99%

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

Ortiz-Álvarez

Delgado-Ramírez

et al. 2018

IDR

View full text Add to dashboard Cite

show abstract

“…(11,13,16,17) Nevertheless, previous studies in Mexico have reported alarmingly high incidences of UTIs caused by ESBL-producing E. coli in the community (56.5%) and in complicated infections (59.8%). (18,19) Infections caused by ESBL-producing bacteria were more frequent in the community than in our hospital setting (76.3% and 23.7%, respectively).…”

Section: Discussionmentioning

confidence: 75%

Resistencia antibiótica y agentes beta-lactamasa de espectro extendido en las infecciones del tracto urinario: un problema grave en el norte de México

et al. 2020

View full text Add to dashboard Cite

Objective: To describe the causal agents, prevalence of antimicrobial resistance, and risk factors associated with extended spectrum beta-lactamase (ESBL)-producing agents in urinary tract infections (UTIs). Materials and methods: A retrospective study was conducted at a tertiary care hospital in Monterrey, Mexico. Inclusion criteria were patients that clinically presented with a UTI and had a positive urine culture, within the time frame of March to October 2017. The association with ESBL-producing agents was determined through the Χ2 test for categorical variables. Statistical significance was set at a p <0.05, utilizing SPSS version 20.0 software. Results: A total of 353 positive urine cultures were confirmed. ESBL production was found in 21.5% of the strains. There was a high level of resistance (>50%) to amoxicillin-clavulanate, ciprofloxacin, levofloxacin, fosfomycin, and trimethoprim-sulfamethoxazole and moderate resistance (10-50%) to gentamicin and ceftriaxone. Amikacin, ertapenem, nitrofurantoin, and colistin had the lowest resistance rates (<10%). The ESBL-producing agents were associated with complicated UTI (p≤0.0001). The comorbidities associated with ESBL-positive UTIs were diabetes mellitus (p=0.02) and immunodeficiency (p=0.008), as was having undergone radiotherapy (p=0.025) and previous antibiotic use (p≤0.001). Limitations: The clonal relationship of isolates, especially of E. coli, was not analyzed. We could not establish whether there was a high level of genetic diversity between the isolates or whether independent acquisition or cross-transmission occurred. Value: We evaluated the epidemiologic characteristics of the ESBL-producing agents in UTIs at a Mexican tertiary care hospital. Conclusions: One out of every five UTIs was caused by ESBLs in our study population. There was a high level of resistance to the antibiotics used as first-line empiric therapy in the patients studied.

show abstract

“…Most cases of urosepsis are secondary to a complicated UTI or pyelonephritis. [6] However, with urosepsis, clinicians should be aware of the risk of abscess formation along the urogenital tract and collections forming in previous cysts. Studies have shown that persisting fever despite adequate antimicrobial cover and patients who have diabetes mellitus or who are immunosuppressed are more likely to develop these complications.…”

Section: Discussionmentioning

confidence: 99%

“…A Mexican study reviewed 173 patients admitted with a complicated UTI. [6] A complicated UTI is associated with any condition that increases the probability of acquiring the infection or not responding to the standard treatment. Obstructive uropathy (73.4%) and urinary stone disease (33.5%) were 2 common factors associated with the development of a complicated UTI.…”

Section: Introductionmentioning

confidence: 99%

Urosepsis and the urologist!

Ryan¹,

O’Neill²,

McLornan³

2021

Current Urology

View full text Add to dashboard Cite

Introduction: Sepsis is a life-threatening organ dysfunction that is caused by a dysregulated host response to the infection. Urosepsis contributes up to 25% of all sepsis cases. An important part of the management of urosepsis is to rule out possible surgical causes such as urolithiasis, obstructive uropathy, or abscess formation along the urogenital tract. Objective: The aim of this study is to look at whether urological conditions and recent urological surgery contribute significantly to all patients admitted with urosepsis. Methods: A total of 2679 urine cultures and 654 blood cultures performed in Connolly Hospital Emergency Department were reviewed between 2016 and 2018. Patients were included if they had a matching urine culture and blood culture performed within 24 hours of admission. A retrospective chart review was performed for all patients included in the study. Results: Our study included 85 patients admitted with urosepsis between 2016 and 2018. The average age was 70.3 years (21–100 years), in which 61% (n = 52) of patients were female, 18% (n = 16) had a long-term indwelling catheter, 11.8% (n = 10) were admitted as urosepsis with a urological condition. The most common urological condition predisposing patients to urosepsis in this study was bladder outlet obstruction secondary to benign prostatic hyperplasia. A total of 4.7% (n = 4) of patients died during their admission. The complications as a result of urosepsis included a prostatic abscess, a psoas abscess, an ileus, an infected cyst, and 1 case of emphysematous pyelonephritis. Conclusion: In this study, the majority of patients admitted with urosepsis did not have an underlying urological condition or recent urological instrumentation. Clinicians should be aware of potential complications as a result of a urosepsis.

show abstract

Management of complicated urinary tract infections in a referral center in Mexico

Abstract: Wide-spectrum antimicrobial therapy and minimally invasive approaches are the most common treatments for CUTIs in our center, and a reevaluation regarding antibiotic use in Mexico needs to be done.

Cited by 7 publications

References 15 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

Resistencia antibiótica y agentes beta-lactamasa de espectro extendido en las infecciones del tracto urinario: un problema grave en el norte de México

Urosepsis and the urologist!

Contact Info

Product

Resources

About