Search Icon
Notification Icon
Ham Icon
Quick Reads icon
Quick Reads
Events & Videos icon
Events & Videos
Explore icon
Explore
Product Index icon
Product Index
eCME icon
eCME

MIC Series-Updates on UTI: Issue 11

calendar
11 Oct, 11

Evaluation of the Difference in Clinical Implications of Healthcare-Associated and Community-Associated Acute Pyelonephritis

Aim

To analyze the differences between community-associated (CA) and healthcare-associated acute pyelonephritis (HCA-APN) with specific interest in antibiotic resistance of causative microorganisms.

Study Design

It is a retrospective cohort study carried out during a 1 year period at a large referral center. It included 319 patients who visited the emergency department with symptoms and signs of APN.

They were classified into,

  • 201 (63%) patients with healthcare-associated acute pyelonephritis (HCA-APN)
  • 118 (37%) patients with community-associated (CA) acute pyelonephritis

Results

  • As compared to patients with CA-APN, patients with HCA-APN had,
    • Higher SOFA (sequential organ failure assessment) scores
    • Longer length of hospital stay
    • Lower rate of complete response to antimicrobial therapy
  • Patients with complicated APN also had characteristics similar to those seen in HCA-APN.
  • However, 14-day mortality rates were not different between CA-APN vs HCA-APN and between uncomplicated APN vs complicated APN.
  • Microbiological characteristics:
    • Causative organism:
      Escherichia coli were found to be less common in HCA-APN than in CA-APN (62.7% vs 93.2%, p < 0.001).
    • E. coli resistance:
      Among E. coli isolates, quinolone resistance (38.9% vs 12.7%, p < 0.001) and extended-spectrum beta-lactamase (ESBL) production (15.9% vs 0.8%, p < 0.001) were more common in HCA-APN than in CA-APN.

Conclusion

HCA-APN and complicated APN represents a distinct subset of urinary tract infections and are associated with more antibiotic-resistant pathogens and worse outcomes. Physicians should consider these factors to provide optimal treatment.

Scand J Infect Dis. 2011. Epub ahead of print.

Related Topics
UTI
arrow

More From Area Of Interest
You may also like
Our Research
Efficacy & Safety of Torsemide & Spironolactone FDC in HF Patients: Insights from RESTORE HF Study
13 May, 26
CiplaMedLogo
13 May, 26
Our Research
Telmisartan & Amlodipine FDC for BP Control in Indian Patients with Hypertension: TACT‑India Study
17 Apr, 26
CiplaMedLogo
17 Apr, 26
Our Research
Physician Perspectives on Breath‑Actuated Inhalers: APPROACH Survey Interim Data
23 Feb, 26
CiplaMedLogo
23 Feb, 26
Our Research
An East region Subgroup Analysis from an Indian Cross-Sectional Study to Evaluate In-Clinic AR Burde...
11 Feb, 26
CiplaMedLogo
11 Feb, 26
Our Research
Role of Acebrophylline and its Combinations in the Management of Obstructive Airway Disease (ROAAD)
11 Feb, 26
CiplaMedLogo
11 Feb, 26
Our Research
In-Clinic AR Burden in Western India: Subgroup Analysis from a Multicenter Cross-Sectional Study Usi...
11 Feb, 26
CiplaMedLogo
11 Feb, 26
Latest Items