Original contribution
Prevalence and risk factors for multidrug resistant uropathogens in ED patients

https://doi.org/10.1016/S0735-6757(00)90005-6Get rights and content

Abstract

The purpose of this study was to describe resistance patterns of infecting organisms and determine risk factors for multidrug resistance in patients with urinary tract infections. Retrospective case series of 435 patients age ≥16 with urinary tract infection. Multidrug resistance was defined as resistance to ≥two classes of antibiotics. Demographic, historical, and microbiological data were collected. Univariate analysis and multivariate logistic regression were used to determine risk factors for multidrug resistance. Multidrug resistance was seen in 37% of isolates. Univariate analysis revealed numerous associations with resistance. Multivariate analysis found three independent factors associated with multidrug resistance: urinary catheter use (odds ratio [OR] 2.6, 95% confidence interval [CI] 1.4 to 4.8), age ≥65 years (OR 3.0, 95% CI 1.7 to 5.4) and antibiotic use (OR 4.6, 95% CI 2.8 to 7.5). Diabetes was also a risk factor when patients with urinary catheters were excluded (OR 2.4, 95% CI 1.1 to 5.3). Resistance was seen in all groups of patients, but was particularly common in older patients and those who used a urinary catheter. Antibiotic use was highly associated with multidrug resistance.

References (21)

There are more references available in the full text version of this article.

Cited by (77)

  • Influence of inadequate antimicrobial therapy on prognosis in elderly patients with severe urinary tract infections

    2014, European Journal of Internal Medicine
    Citation Excerpt :

    Elderly patients with UTI admitted to hospital usually have a high number of comorbidities, a history of admissions to hospital, chronic carriers of urinary catheters and previous use of antibiotics. All these factors are related to infections caused by drug resistant microorganisms and to inadequate empirical antimicrobial therapy (IEAT) [3,4]. IEAT is associated with poor prognosis in severe infections such as pneumonia, meningitis, bacteremia and peritonitis in the general population [5,6].

View all citing articles on Scopus

Presented at the Society for Academic Emergency Medicine, Annual Meeting, May 1998

View full text