Community Acquired Infection

ORIGINAL ARTICLE
Year
: 2017  |  Volume : 4  |  Issue : 1  |  Page : 1--5

Management of community-acquired urinary tract infection in a tertiary care setting: A prospective study


M Madhu Bashini1, S Jeevitha1, G Balajee2, Vijaya Srinivasan3 
1 Department of Internal Medicine and Diabetology, Global Hospitals, Chennai, Tamil Nadu, India
2 Department of Microbiology, Global Hospitals, Chennai, Tamil Nadu, India
3 Department of Research and Academics, Global Hospitals, Chennai, Tamil Nadu, India

Correspondence Address:
M Madhu Bashini
Global Hospitals, Cheran Nagar, Perumbakkam, Chennai - 600 100, Tamil Nadu
India

Background and Objectives: Carbapenems and beta-lactam-beta-lactamase inhibitors are empirical drugs of choice in the treatment of urinary tract infection. (UTI); however, de-escalation of therapy is necessary to ensure compliance. Objectives: The objective is to study the impact of antibiotic susceptibility report on the management of community-acquired UTI. Materials and Methods: Patients were classified prospectively as uncomplicated UTI (UC-UTI) and complicated UTI (C-UTI), and symptoms, microbiology, antibiotic susceptibility pattern, and treatment modification following culture report were analyzed. Extended spectrum beta-lactamase (ESBL) prevalence in patients was compared among naive and those who received empirical treatment before presentation. Patients with a history of recurrent UTI were given prophylaxis and all were followed up for 1 month. SPSS version 20 package was used for statistical analysis. Results: Nearly 75% of the study population had C-UTI. Around 70% of C-UTI and 50% of UC-UTI had ESBL-producing Gram-negative enterobacteriace. In UC-UTI, failed empirical treatment before presentation at our center was significantly associated with positive ESBL producer status. Sensitivity to amikacin and carbapenems was over. 90%; nitrofurantoin and piperacillin-tazobactam followed at around 70%. Following culture report, a significant number of C-UTI were de-escalated to oral regimens. Conclusions: Despite the high prevalence of ESBL-producing pathogens in community.acquired UTI, once systemic signs of sepsis are controlled, de-escalation is possible in the majority of patients.


How to cite this article:
Bashini M M, Jeevitha S, Balajee G, Srinivasan V. Management of community-acquired urinary tract infection in a tertiary care setting: A prospective study.Community Acquir Infect 2017;4:1-5


How to cite this URL:
Bashini M M, Jeevitha S, Balajee G, Srinivasan V. Management of community-acquired urinary tract infection in a tertiary care setting: A prospective study. Community Acquir Infect [serial online] 2017 [cited 2022 May 17 ];4:1-5
Available from: http://www.caijournal.com/article.asp?issn=2225-6482;year=2017;volume=4;issue=1;spage=1;epage=5;aulast=Bashini;type=0