1865. Antibiotic Susceptibilities of Organisms Isolated from Urine Cultures of Patients Diagnosed with a Urinary Tract Infection (UTI) and Discharged from the Emergency Department (ED)
Session: Poster Abstract Session: Antimicrobial Stewardship: Potpourri
Saturday, October 6, 2018
Room: S Poster Hall
Posters
  • Patrizia Favale IDSA Poster.pdf (737.9 kB)
  • Background: Urinary tract infections (UTIs) are among the most commonly treated infections in the Emergency Department (ED). Treatment is largely empiric and based on an institution-wide antibiogram comprised of isolates from all infection sites, which may overestimate antibiotic resistance of urinary pathogens of non-admitted ED patients. The primary goal of this study is to determine the antibiotic susceptibilities of urinary pathogens isolated from adult patients with a UTI and discharged from the ED.

    Methods: This was a single-center, retrospective chart review of adult patients discharged from the ED with a UTI from August to December 2017. Descriptive statistics were used to compare the antibiotic susceptibilities of pathogens isolated from urine cultures to the institutional and local Brooklyn antibiogram. Antibiotic susceptibilities were determined by MicroScan. Data on antibiotic prescribing patterns and previously described risk factors for multidrug resistant organisms were collected.

    Results: 246 patients were included with 267 isolates identified. 61% (151) of patients were between ages 18 to 65 years old and 73% (180) were female. The most common organism isolated was Escherichia coli (164, 62%). E. coli urine isolates were most susceptible to nitrofurantoin (98%) followed by cefazolin (81%), ciprofloxacin (84%) and sulfamethoxazole/trimethoprim (64%). There was no difference in susceptibility rates of E. coli to cefazolin or sulfamethoxazole/trimethoprim but isolates were more susceptible to ciprofloxacin in the ED compared to the institutional antibiogram (84% vs. 70%). 26 (10.6%) patients grew an ESBL organism and of these, 42% (11/26) had no identifiable healthcare exposure within the last 90 days.

    Conclusion: Despite limitations in sample size, this study supports using separate antibiograms and pathways for the treatment of UTI in the ED, especially in a community with high rates of local resistance to first-line agents.

    Patrizia Favale, PharmD1, Rosanna Li, PharmD2, Sam Simon, PharmD2, Nechama Rothberger, PharmD2 and Suri Mayer, PharmD2, (1)Pharmacy, Maimonides Medical Center, Brooklyn, NY, (2)Maimonides Medical Center, Brooklyn, NY

    Disclosures:

    P. Favale, None

    R. Li, None

    S. Simon, None

    N. Rothberger, None

    S. Mayer, None

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 3rd with the exception of research findings presented at the IDWeek press conferences.