Community-onset Bacteremic Urinary Tract Infections Caused by Extended-spectrum Beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae

There is an in increase in community-onset bacteremic urinary tract infections (UTIs) caused by Escherichia coli and Klebsiella pneumoniae. Among these, extended-spectrum beta-lactamase (ESBL)-producing E. coli and K. pneumoniae (ESBL-EK) are the most prevalent in Taiwan. Methods: This study was conducted retrospectively from January 2003-June 2008 and 22 patients were enrolled. Diagnosis was based on the findings of at least one positive blood culture disclosing the same pathogen as urine culture on admission. Results: The proportion of patients with indwelling urinary catheters was 41.0% and the proportion for patients from healthcare facilities was 50%. Mean Acute Physiology and Chronic Health Evaluation Ⅱ scores were 22.1±6.3. The rate of intensive care unit (ICU) admission was 27.3%. The mortality rate was 4.5%. The mean hospital stay was 14.5±7.9 days. Up to 72.7% of 22 patients received inappropriate antibiotic therapy. The mean expenditure on antibiotics was 533.2±370.2 USDs. Conclusions: Among the patients, the proportions of male gender patients, patients with urinary catheter indwelling and residents from healthcare facilities were high. Though the majority of them received inappropriate antibiotic treatment, the mortality rate was low.

並列關鍵字

bacteremia ； extended-spectrum beta-lactamase ； urinary tract infection ； community

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