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Treatment, outcomes...
Treatment, outcomes and characterization of pathogens in urinary tract infections caused by ESBL-producing Enterobacterales : a prospective multicentre study
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- Montelin, Hanna, 1984- (author)
- Uppsala universitet,Infektionsmedicin,Uppsala Univ, Sweden,Department of Medical Sciences, Section of Infectious Diseases, Uppsala University, Uppsala, Sweden
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- Camporeale, Angela (author)
- Karolinska Inst, Sweden,Department of Laboratory Medicine, Division of Clinical Microbiology, Karolinska Institutet, Stockholm, Sweden
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- Hallgren, Anna, 1984- (author)
- Uppsala universitet,Infektionsmedicin,Uppsala Univ, Sweden,Department of Medical Sciences, Section of Infectious Diseases, Uppsala University, Uppsala, Sweden
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- Angelin, Martin (author)
- Umeå universitet,Institutionen för klinisk mikrobiologi
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- Hogvall, Jonas (author)
- Karlstad Cent Hosp, Sweden,Department of Infectious Diseases, Karlstad Central Hospital, Karlstad, Sweden
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- Östholm, Åse (author)
- Linköpings universitet,Avdelningen för inflammation och infektion,Medicinska fakulteten,Region Östergötland, Infektionskliniken i Östergötland,Department of Biomedical and Clinical Sciences, Division of Infectious Diseases, Linköping University, Linköping, Sweden
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- Vading, Malin (author)
- Karolinska Inst, Sweden,Department of Laboratory Medicine, Division of Clinical Microbiology, Karolinska Institutet, Stockholm, Sweden; Department of Infectious Diseases, Danderyds Hospital, Stockholm, Sweden
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- Giske, Christian G (author)
- Karolinska Institutet,Karolinska Inst, Sweden; Karolinska Univ Hosp, Sweden,Department of Laboratory Medicine, Division of Clinical Microbiology, Karolinska Institutet, Stockholm, Sweden; Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden
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- Tängdén, Thomas, 1976- (author)
- Uppsala universitet,Infektionsmedicin,Uppsala Univ, Sweden,Department of Medical Sciences, Section of Infectious Diseases, Uppsala University, Uppsala, Sweden
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(creator_code:org_t)
- 2024
- English.
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In: Journal of Antimicrobial Chemotherapy. - : OXFORD UNIV PRESS. - 0305-7453 .- 1460-2091.
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Abstract
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- Objectives: Treatment options for urinary tract infections (UTIs) caused by ESBL-producing Enterobacterales are limited. Moreover, evidence to support therapeutic decisions is lacking. This study assessed current treatment strategies and patient and pathogen characteristics in relation to clinical and microbiological outcomes.Methods: Patients with UTI caused by ESBL-producing Enterobacterales were prospectively recruited by investigators at 15 infectious disease hospital departments. Data were collected on patient characteristics, treatments, clinical and microbiological cure 10–14 days after the end of treatment, and relapse within 3 months. Bacterial isolates were subjected to MIC determination and WGS.Results: In total, 235 patients (107 febrile UTI, 128 lower UTI) caused by Escherichia coli (n = 223) and Klebsiella spp. (n = 12) were included. Clinical and microbiological cure rates were 83% and 64% in febrile UTI, and 79% and 65% in lower UTI. Great variability in treatments was observed, especially in oral therapy for febrile UTI. No difference was seen in clinical outcomes with piperacillin/tazobactam (n = 28) compared with carbapenems (n = 41). Pivmecillinam was frequently used in lower UTI (n = 62), and was also associated with high clinical cure rates when used as initial therapy (10/10) or follow-up (7/8) for febrile UTI. Recurrent infection, diabetes mellitus and urogenital disease were associated (P < 0.05) with clinical failure and relapse. In E. coli, ST131 was significantly associated with relapse, and haemolysin with microbiological failure or relapse.Conclusions: Antibiotic treatments were highly variable. Patient and pathogen factors were identified as potential determinants of disease presentation and outcomes and may prove useful to guide individualized treatment and follow-up.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Infektionsmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Infectious Medicine (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Medicinska och farmaceutiska grundvetenskaper -- Mikrobiologi inom det medicinska området (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Basic Medicine -- Microbiology in the medical area (hsv//eng)
Keyword
- UTI
- antibiotic treatment
- ESBL-producing Enterobacterales
- Infektionssjukdomar
- Infectious Diseases
Publication and Content Type
- ref (subject category)
- art (subject category)
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Montelin, Hanna, ...
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Camporeale, Ange ...
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Hallgren, Anna, ...
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Angelin, Martin
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Hogvall, Jonas
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Östholm, Åse
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Vading, Malin
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Giske, Christian ...
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Tängdén, Thomas, ...
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Infectious Medic ...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Basic Medicine
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and Microbiology in ...
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Journal of Antim ...
- By the university
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Uppsala University
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Karolinska Institutet
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Linköping University
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Umeå University