Methods: Single center retrospective study between May-October 2014. First, our UA was developed by reviewing antibiotic susceptibilities of all inpatient urine isolates. It was then compared to the RGH SA. Secondly, chart review of inpatient admissions to the corresponding E. coli isolates were done to identify more than 20 patient factors.
Results: 856 isolates were included in the UA. In comparison to the SA, urine isolates had a higher ESBL prevalence (7% UA vs. 4% SA, p=0.02) and tended to be more resistant to antibiotics, most notably Ciprofloxacin (Cipro) (74% vs 79% susceptible, p= 0.03). Of the 480 urine E. coli isolates (49%), there were several patient factors that impacted Cipro susceptibility. Prior history of ESBL (7% vs. 76%, p= <0.001, OR 9.9 CI 1.0-94.0), MDRO (29% vs. 79%, p=<0.001, OR 4.9, CI 2.0-12.0) or VRE (32% vs. 76%, p= 0.002, OR 6.9 CI 2.0-24.0), antibiotics in past 90 days (59% vs. 81%, p=0.007, OR 2.9 CI 1.3-6.5), nursing home residence (39% vs. 77% p= <0.001, OR 4.9 CI 2.3-10.0), history of kidney stone (62% vs. 75%, p=0.007, OR 3.0, CI 1.3-6.6), and immunocompromised status (60% vs. 75%, p=0.02, OR 2.9 CI 1.2-7.4) were factors found to be statistically significant in multivariate analysis.
Conclusion: At RGH in comparison to the SA, the UA revealed increased resistance to several antibiotic drug classes, with Cipro susceptiblity being impacted significantly by several patient factors. Therefore, when selecting empiric antibiotics for the treatment of UTIs, caution should be used when choosing Cipro and risk factors should be considered.
M. Hite, None
J. Hashim, None