Introduction: Urinary tract infections (UTI) are often treated in the emergency department (ED) with Escherichia coli being the most likely cause. E.coli resistance has increased for many common antibiotics, but rates vary depending on risk of drug resistance in each population. We stratified ED patients into two groups based on risk factors for drug resistant pathogens (DRP), community (CA-UTI) or healthcare (HA-UTI)-associated UTI, and evaluated rates of E. coli resistance. We repeated this evaluation after a 10-year period to assess resistance trends. Research Question or Hypothesis: E.coli resistance will increase in CA-UTI patients over a 10-year period. Study Design: Two identical retrospective medical record evaluations of patients treated in the ED for UTI were performed over a 10-year period (2011,2021). We evaluated rates of E.coli resistance and changes over time. ED-patients with a positive urine culture (>100,000 cfu/mL) treated for UTI and discharged with an antibiotic prescription were included. Exclusion criteria were age 2 days, previous antibiotics, urologic procedure in last 90 days, and chronic dialysis in last 30 days. Methods: The CA-UTI data sets were compared for changes in E. coli resistance to levofloxacin, nitrofurantoin, cefazolin and sulfamethoxazole-trimethoprim. Data sets were compared utilizing appropriate parametric or non-parametric statistical tests. Results: Data sets were similar except for higher percentage of males and mean age in 2021. In 2011 and 2021 respectively, E. coli resistance was 9.2% vs 9.9% to levofloxacin, 8.9% vs 6% for cefazolin, 25.2% vs. 26.6% for SMX/TMP, and 8.4% vs. 2.6% for nitrofurantoin. Conclusion: Changes in CA-UTI E. coli resistance over a 10-year period were most notably improved for NTF, and not significantly different for levofloxacin, cefazolin, or SMX/TMP.
展开▼
