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BMC Res Notes. 2017 Jul 27;10(1):336. doi: 10.1186/s13104-017-2680-z.

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

Author information

1
National Center for Global Health and Medicine, Disease Control and Prevention Center, Toyama 1-21-1, Shinjuku, Tokyo, 162-8655, Japan. mawatamo@gmail.com.
2
Gunma University Hospital, Infection Control and Prevention Center, Showa 3-39-15, Maebashi, Gunma, 371-8511, Japan. mawatamo@gmail.com.
3
National Center for Global Health and Medicine, Disease Control and Prevention Center, Toyama 1-21-1, Shinjuku, Tokyo, 162-8655, Japan.

Abstract

OBJECTIVES:

This 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.

RESULTS:

A 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.

KEYWORDS:

Community; ESBL-producing Enterobacteriaceae; Non-carbapenem β-lactam; Urinary tract infection

PMID:
28750653
PMCID:
PMC5531016
DOI:
10.1186/s13104-017-2680-z
[Indexed for MEDLINE]
Free PMC Article

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