Abstract | BACKGROUND: METHODS: Adults presenting to 11 US emergency departments with (1) flank pain and/or costovertebral tenderness, (2) temperature >38 degrees C, and (3) a presumptive diagnosis of pyelonephritis were enrolled; patients for whom 1 uropathogen grew on culture were analyzed. Epidemiologic and clinical data were collected at the time of care. The prevalence of E. coli in vitro antibiotic resistance and risk factors associated with TMP-SMX-resistant E. coli infection were determined. RESULTS: Among 403 women with uncomplicated pyelonephritis caused by E. coli, the mean site rate of E. coli resistance to TMP-SMX was 24% (range, 13%-45%). Mean site rates of E. coli resistance to ciprofloxacin and levofloxacin were 1% and 3%, respectively. Only TMP-SMX exposure within 2 days before presentation and Hispanic ethnicity were associated with E. coli resistance to TMP-SMX (compared with resistance rates of approximately 20% among women lacking these risk factors); antibiotic exposure within 3-60 days before presentation, health care setting exposure within 30 days before presentation, history of urinary tract infections, and age >55 years were not associated with E. coli resistance to TMP-SMX. Among 207 patients with complicated pyelonephritis, mean site rates of E. coli resistance to ciprofloxacin and levofloxacin were 5% and 6%, respectively. CONCLUSIONS:
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Authors | David A Talan, Anusha Krishnadasan, Fredrick M Abrahamian, Walter E Stamm, Gregory J Moran, EMERGEncy ID NET Study Group |
Journal | Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
(Clin Infect Dis)
Vol. 47
Issue 9
Pg. 1150-8
(Nov 01 2008)
ISSN: 1537-6591 [Electronic] United States |
PMID | 18808361
(Publication Type: Journal Article, Multicenter Study, Research Support, U.S. Gov't, P.H.S.)
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Chemical References |
- Fluoroquinolones
- Ciprofloxacin
- Levofloxacin
- Trimethoprim, Sulfamethoxazole Drug Combination
- Ofloxacin
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Topics |
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Ciprofloxacin
(pharmacology)
- Cross-Sectional Studies
- Drug Resistance, Bacterial
- Emergencies
- Escherichia coli
(drug effects)
- Escherichia coli Infections
(drug therapy, epidemiology, etiology)
- Female
- Fluoroquinolones
(pharmacology)
- Humans
- Levofloxacin
- Middle Aged
- Ofloxacin
(pharmacology)
- Pyelonephritis
(drug therapy, epidemiology, etiology)
- Risk Factors
- Trimethoprim, Sulfamethoxazole Drug Combination
(pharmacology)
- United States
(epidemiology)
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