Effect of prior receipt of antibiotics on the pathogen distribution and antibiotic resistance profile of key Gram-negative pathogens among patients with hospital-onset urinary tract infections.

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dc.contributor.authorBidell, Monique R
dc.contributor.authorOpraseuth, Melissa Palchak
dc.contributor.authorYoon, Min J
dc.contributor.authorMohr, John F
dc.contributor.authorLodise, Thomas P
dc.contributor.orcidhttps://orcid.org/0000-0002-4730-0655
dc.date.accessioned2025-02-07T19:34:55Z
dc.date.available2025-02-07T19:34:55Z
dc.date.issued2/28/2017
dc.description.abstractBACKGROUND: This retrospective cohort study characterized the impact of prior antibiotic exposure on distribution and nonsusceptibility profiles of Gram-negative pathogens causing hospital-onset urinary tract infections (UTI). METHODS: Hospital patients with positive urine culture for Pseudomonas aeruginosa, Escherichia coli, Klebsiella pneumoniae, and other Enterobacteriaceae >/=3 days after hospital admission were included. Assessment outcomes included the distribution of bacteria in urine cultures, antibiotic susceptibility patterns, and the effect of prior antibiotic exposure, defined as 0, 1, or >/=2 prior antibiotics, on the distribution and antibiotic susceptibility profiles of the Gram-negative organisms. RESULTS: The most commonly isolated pathogens from 5574 unique UTI episodes (2027 with and 3547 without prior antibiotic exposure) were E. coli (49.5%), K. pneumoniae (17.1%), and P. aeruginosa (8.2%). P. aeruginosa was significantly more commonly isolated in patients with >/=2 prior antibiotic exposures (12.6%) compared with no exposure (8.2%; p = 0.036) or 1 prior exposure (7.9%; p = 0.025). Two or more prior antibiotic exposures were associated with slightly higher incidences of fluoroquinolone nonsusceptibility, multidrug resistance, and extended-spectrum beta-lactamase phenotype compared with 0 or 1 exposure, suggesting an increased risk for resistant Gram-negative pathogens among hospital patients with urinary tract infections occurring >/=3 days after admission. CONCLUSIONS: Clinicians should critically assess prior antibiotic exposure when selecting empirical therapy for patients with hospital-onset urinary tract infections caused by Gram-negative pathogens.
dc.description.urihttps://doi.org/10.1186/s12879-017-2270-7
dc.description.urihttp://www.ncbi.nlm.nih.gov/pmc/articles/pmc5329905
dc.identifier.citationBidell MR, Opraseuth MP, Yoon M, Mohr J, Lodise TP. Effect of prior receipt of antibiotics on the pathogen distribution and antibiotic resistance profile of key Gram-negative pathogens among patients with hospital-onset urinary tract infections. BMC Infect Dis. 2017 Feb 28;17(1):176. doi: 10.1186/s12879-017-2270-7. PMID: 28241755; PMCID: PMC5329905.
dc.identifier.issn1471-2334
dc.identifier.other28241755
dc.identifier.urihttps://hdl.handle.net/20.500.14303/707
dc.language.isoen
dc.publisherBioMed Central
dc.relation.ispartofBMC Infectious Diseases
dc.rightsThis Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. For other uses you need to obtain permission from the rights-holder(s). http://rightsstatements.org/vocab/InC/1.0/
dc.subjectAnti-Bacterial Agents/pharmacology
dc.subjectCross Infection/diagnosis/microbiology
dc.subjectDrug Resistance, Bacterial/drug effects
dc.subjectGram-Negative Bacteria/drug effects/isolation & purification
dc.subjectGram-Negative Bacterial Infections/diagnosis/microbiology
dc.subjectRetrospective Studies
dc.subjectRisk Factors
dc.subjectUrinary Tract Infections/diagnosis/microbiology
dc.titleEffect of prior receipt of antibiotics on the pathogen distribution and antibiotic resistance profile of key Gram-negative pathogens among patients with hospital-onset urinary tract infections.
dc.typeArticle
local.departmentprogramDepartment of Pharmacy Practice
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