Pyelonephritis at an Urban Medical Center: Prevalence of Antimicrobial Resistance and Process of Care

Abstract:

Pyelonephritis is common, but few studies of the clinical aspects of urinary tract infection have focused exclusively on pyelonephritis and there is little information available regarding the prevalence of antimicrobial resistance and the process of care for patients hospitalized with pyelonephritis. Records of patients hospitalized with acute pyelonephritis during a 2-year period were reviewed. Demographic data, comorbidities, results of urine and blood cultures, and data regarding antimicrobial therapy and the use of diagnostic imaging were recorded. The associations between bacteremia and demographic characteristics, infection with a resistant uropathogen, and the use and results of diagnostic imaging were examined. Most patients hospitalized for pyelonephritis were young women; however, 52.8% had some underlying chronic disease and 19.4% had a structural or functional abnormality of the urinary tract. Escherichia coli was responsible for 85% of infections; 26% of these isolates were resistant to trimethoprim-sulfamethoxazole. Ampicillin in combination with gentamicin was the initial therapy in most patients (70%). Bacteremia occurred in 53% of patients; no relationship between the risk of bacteremia and the demographic characteristics or infection with a trimethoprim-sulfamethoxazole-resistant isolate could be demonstrated. Bacteremic patients were less likely to undergo diagnostic imaging (58.1% vs. 81.5%, P = 0.04) but had a longer length of stay (5.8 vs. 3.7 days, P = 0.01).

Año de publicación:

2002

Keywords:

Fuente:

scopus