40513. Trends of Antibiotic Resistance of Bacteria Causing Urinary Tract Infection
Session: Poster Abstract Session: Medical Student Poster Session
Friday, October 4, 2013
Room: Yerba Buena Ballrooms
Background:  

Certain bacterial strains cause recurrent UTIs in patients with established risk factors such as diabetes mellitus (DM) and indwelling catheters. We report our findings on the antibiotic resistance pattern of UTI causing bacteria within our community by doing a snap shot observation.

Methods:  

We conducted a snap shot retrospective chart-review of 192 patients evaluated in the Emergency Department of an urban community teaching hospital from January 2010 to March 2010. Data regarding culture isolates and associated antimicrobial resistance, diabetic status, pregnancy status, age and gender were collected and analyzed.

Results:

Of the total 192 isolates that were identified, 87 (45.3%) were Escherichia coli (E. coli), 32 (16.7%) were Klebsiella pneumoniae (KP) and 23 (12%) were Proteus mirabilis(PM), among other isolates not commonly causing UTI. The average age of the patients was 62 years:  58 (30.7%) were < 50 years; 133 patients (69.3%) were > 50 years. DM was present in 74 patients (38.5%). Eight patients (4.2%) were pregnant. Forty-four patients (23%) were male and 148 patients (77%) were female. Antimicrobial resistance analysis indicated the following resistant pattern of KP: 56.3% to ciprofloxacin, 56.0% to trimethoprim/sulfamethoxazole (TMP/SMX), 53.1% to carbapenems, 62.5% to nitrofurantoin and 34.4% to cefoxitin. The resistance pattern of E. coli was 36.8 % to ciprofloxacin, 46% to TMP/SMX, 8% to nitrofurantoin and 9.2% to cefoxitin. The resistance pattern of PM was 34.8% to ciprofloxacin, 39% to TMP/SMX, 78.3% to nitrofurantoin and 17.4% to cefoxitin. No resistance of E. coli and PM was observed to the carbapenem group. E. coli demonstrated less resistance to cefoxitin and nitrofurantoin. Almost all carbapenem resistant KP were recovered from urine samples of diabetic patients.

Conclusion:  

We found increasing resistance of UTI causing pathogens to commonly used antimicrobial agents. Particularly alarming was the resistance pattern noted in diabetic patients to the carbapenem class agents. Care must be taken to ensure appropriate antibiotic treatment and follow-up of patients with UTI’s particularly those with recurrent infections which may serve as a clinical marker of infection with antibiotic resistant organisms.

Tun T Aung, MD1, Arpine Saribekyan, MD1, Melissa Herschman, RN2, Maaz Usmani2, Anuj Sharma2, Bonnie Simmons, DO3, Shakeel Usmani, MD3 and Getaw Worku Hassen, MD, PhD3, (1)Family Medicine, Lutheran Medical Center, Brooklyn, NY, (2)St. George's University School of Medicine, University Centre, Grenada, (3)Emergency Medicine, Lutheran Medical Center, Brooklyn, NY

Disclosures:

T. T. Aung, None

A. Saribekyan, None

M. Herschman, None

M. Usmani, None

A. Sharma, None

B. Simmons, None

S. Usmani, None

G. W. Hassen, None

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