Comparison of intravenous and oral definitive antibiotic regimens in hospitalised patients with Gram-negative bacteraemia from a urinary tract infection

This study compared treatment failures between patients treated exclusively with IV antibiotics and those transitioned from IV to oral antibiotics for bacteraemia secondary to UTI.MethodsThis single-centre, retrospective cohort study included hospitalised, non-critically ill adult patients treated with culture-susceptible antibiotic therapy for 7–21 days. Patients were divided into two cohorts based on the route of definitive antibiotic administration. Treatment failure was a composite outcome of death and recurrence of the index micro-organism within 21 days following negative blood cultures.Results and discussionAmong the 346 patients enrolled, 82 (23.7%) were in the IV cohort and 264 (76.3%) were in the IV-to-oral cohort. A total of six treatment failures occurred; 2 (2.4%) in the IV cohort and 4 (1.5%) in the oral transition cohort (hazard ratio = 0.62, 95% confidence interval 0.11–3.39; P = 0.58). All failures were due to recurrence of the index organism. Secondary outcomes demonstrated a significantly higher rate of IV line-associated complications in the IV cohort (P = 0.03) and a favourable hospital length of stay in the oral cohort (P 
Source: Journal of Global Antimicrobial Resistance - Category: Infectious Diseases Source Type: research

Related Links:

Publication date: Available online 13 September 2019Source: Journal of Global Antimicrobial ResistanceAuthor(s): Vladimir Rafalskiy, Dmitry Pushkar, Sergey Yakovlev, Oleg Epstein, Mikhail Putilovskiy, Sergey Tarasov, Alexey Glazunov, Sergeiy Korenev, Ekaterina Moiseeva, Natalia GorelyshevaAbstractBackgroundUrinary tract infections (UTIs) are among the most common bacterial infections in clinical practice. The aim of the RESOURCE study was to determine the antimicrobial resistance profile of gram-negative bacteria isolated from outpatient urine samples collected across the Russian Federation.MethodsA total of 96,781 urine s...
Source: Journal of Global Antimicrobial Resistance - Category: Infectious Diseases Source Type: research
ConclusionThese data offer novel information for comparative genomic analyses, in order to track transmission dynamics and the epidemiology of the newly emerging high-risk clone ST307.
Source: Journal of Global Antimicrobial Resistance - Category: Infectious Diseases Source Type: research
Here, we investigated omptin protease ‐mediated antimicrobial resistance among uropathogenicEscherichia coli clinical isolates. We found that clinical isolates with the highest omptin protease activity encode multiple omptin proteases, showing different substrate specificities. Our data suggest that the presence of multiple omptin family proteases in a single clinical isolate may provide a fitness advantage by expanding the range of natural antimicrobial peptides cleaved during urogenital tract colonization. AbstractBacterial colonization of the urogenital tract is limited by innate defenses, including the production of ...
Source: MicrobiologyOpen - Category: Microbiology Authors: Tags: SPECIAL ISSUE: ANTIMICROBIAL RESISTANCE Source Type: research
Escherichia coli has found to be the predominant uropathogen (50 –90%) in uncomplicated, community acquired urinary tract infection (UTI). Uropathogenic Escherichia coli (UPEC) express a multitude of virulence fac...
Source: BMC Microbiology - Category: Microbiology Authors: Tags: Research article Source Type: research
Today’s molecular diagnostics testing typically involves either manual processing at a reference laboratory or automated processing by preconfigured instruments in near-patient settings, Dr. Jack Regan, CEO and founder of LexaGene, tells MD+DI. Neither approach would be ideal for detecting a highly infectious novel pathogen, he warned. The inability to rapidly configure a near-patient instrument to identify a newly emergent pathogen could result in delayed detection and increase the risk of the disease spreading. Some healthcare experts fear that such delays could lead to a pandemic that could claim thous...
Source: MDDI - Category: Medical Devices Authors: Tags: IVD Source Type: news
ConclusionsPrior use of cephalosporin or BLBLI combination antibiotics increased the risk ratio forESBL-producingE. coli infection. Hypoproteinemia and severe disease are independent risk factors for death in patients withE. coli BSIs. There was no significant difference in the 28  day prognosis of patients with ESBL-producingE. coli and those with non-ESBL-producingE. coli BSIs. These data do not support the conclusion that carbapenems might be more effective than BLBLI antibiotics for treatment of patients with BSIs caused by ESBL-producingE. coli.
Source: Antimicrobial Resistance and Infection Control - Category: Infectious Diseases Source Type: research
ConclusionsThis study shows how continuous electronic incidence surveillance based on existing hospital electronic databases can provide a practical means of measuring hospital-wide HAI incidence. The estimated incidence trends demonstrate the necessity for improved infection control measures related to bloodstream infections, ventilator-associated pneumonia, non-intensive care patients, and non-device-associated HAIs, especially during summer months.
Source: Antimicrobial Resistance and Infection Control - Category: Infectious Diseases Source Type: research
Given increasing antimicrobial resistance, we aimed to determine antibiotic susceptibility and presence of resistance genes in uropathogens in primary care, factors associated with resistance to commonly prescribed antibiotics, and effect of treatment on early symptom resolution. We conducted a prospective study of primary care patients with urinary tract infection (UTI) symptoms and culture-confirmed UTI in Singapore from 2015 to 2016. Cohort characteristics and antimicrobial susceptibility of cultured isolates were analyzed. Among Enterobacteriaceae isolates, early symptom resolution (within 3 days) according to antibiot...
Source: Journal of Clinical Microbiology - Category: Microbiology Authors: Tags: Bacteriology Source Type: research
Antibiotics are standard treatment for asymptomatic and symptomatic urinary tract infections (UTIs) in pregnancy. Their overuse, however, can contribute to antimicrobial resistance (AMR) and expose the foetus ...
Source: BMC Pregnancy and Childbirth - Category: OBGYN Authors: Tags: Research article Source Type: research
ConclusionInterventions to improve diagnosis and prescribing for UTIs in older adults typically focus on educating clinicians. Drawing on the sociological concept of translation and interviews with staff and patients our findings suggest that inappropriate diagnosis and antibiotic prescribing in hospitals can be fuelled by gaps in communication or translation between different staff groups and older adult patients, using different languages and technologies or interpreting them differently. We suggest that interventions in this area may be improved by also addressing discrepant understandings and communication about sympto...
Source: Antimicrobial Resistance and Infection Control - Category: Infectious Diseases Source Type: research
More News: Antibiotic Therapy | Antimicrobial Resistance | Hospitals | Infectious Diseases | IV Therapy | Study | Urinary Tract Infections