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10.1128/AAC.01317-17 http://scihub22266oqcxt.onion/10.1128/AAC.01317-17 C5700303!5700303 !28971876     free     free     free Warning: file_get_contents(https://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=28971876 &cmd=llinks): Failed to open stream: HTTP request failed! 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A Cohort Study of Risk Factors That Influence Empirical Treatment of Patients with Acute Pyelonephritis |pdf=|usr=}}{{28971876 }} gab.com Text A Cohort Study of Risk Factors That Influence Empirical Treatment of Patients with Acute Pyelonephritis JO: Antimicrob Agents Chemother http://www.kidney.de/pget.php?&tw=1&pmid=28971876 #FOAvip The aim of the current study was to compare community-acquired acute pyelonephritis (CA-APN) with health care-associated acute pyelonephritis (HCA-APN), describe the outcomes, and identify variables that could predict antimicrobial susceptibility. We conducted an observational study that included all consecutive episodes of acute pyelonephritis (APN) in adults during 2014 at a Spanish university hospital. From each episode, demographic data, comorbidities, clinical presentation, microbiological data, antimicrobial therapy, and outcome were recorded. A multivariable logistic regression model was performed to define the variables associated with antimicrobial resistance. A total of 607 patients, 503 (82.9%) with CA-APN and 104 (17.1%) with HCA-APN, were included in the study. Patients with HCA-APN were older than patients with CA-APN (70.4 versus 50.6 years; P < 0.001) and had higher rates of previous urinary tract infections (UTIs) (56.5% versus 24.5%; P < 0.001) and previous antibiotic use (56.8% versus 22.8%; P < 0.001). Escherichia coli was more frequently isolated from patients with CA-APN than from patients with HCA-APN (79.9% versus 50.5%; P < 0.001). The rates of resistance of Escherichia coli strains from CA-APN patients versus HCA-APN patients were as follows: amoxicillin-clavulanic acid, 22.4% versus 53.2% (P = 0.001); cefuroxime, 7.7% versus 43.5% (P = 0.001); cefotaxime, 4.3% versus 32.6% (P < 0.001); ciprofloxacin, 22.8% versus 74.5% (P < 0.001); and co-trimoxazole, 34.5% versus 58.7% (P = 0.003). The site of acquisition, recurrent UTIs, and previous antibiotic use were independent risk factors for antimicrobial resistance. Relapse rates were significantly higher when definitive antimicrobial treatment was not adequate (37.1% versus 9.3% when definitive antimicrobial treatment was adequate; P < 0.001). Our study reflects the rise of resistance to commonly used antibiotics in acute pyelonephritis. In order to choose the adequate empirical antibiotic therapy, risk factors for resistance should be considered. Twit Text FOAVip A Cohort Study of Risk Factors That Influence Empirical Treatment of Patients with Acute Pyelonephritis ????Antimicrob Agents Chemother http://www.kidney.de/pget.php?&tw=1&pmid=28971876 #FOAvip Twit Text # Free Paper on # # # # # LINK http://www.kidney.de/pget.php?&tw=1&pmid=28971876 #FOAvip English Wikipedia <ref>{{Cite pmid|28971876 }}</ref> A Cohort Study of Risk Factors That Influence Empirical Treatment of Patients with Acute Pyelonephritis #MMPMID28971876 Bosch-Nicolau P ; Falcó V ; Viñado B ; Andreu A ; Len O ; Almirante B ; Pigrau C Antimicrob Agents Chemother 2017[Dec]; 61 (12 ): ä PMID28971876 show ga The aim of the current study was to compare community-acquired acute pyelonephritis (CA-APN) with health care-associated acute pyelonephritis (HCA-APN), describe the outcomes, and identify variables that could predict antimicrobial susceptibility. We conducted an observational study that included all consecutive episodes of acute pyelonephritis (APN) in adults during 2014 at a Spanish university hospital. From each episode, demographic data, comorbidities, clinical presentation, microbiological data, antimicrobial therapy, and outcome were recorded. A multivariable logistic regression model was performed to define the variables associated with antimicrobial resistance. A total of 607 patients, 503 (82.9%) with CA-APN and 104 (17.1%) with HCA-APN, were included in the study. Patients with HCA-APN were older than patients with CA-APN (70.4 versus 50.6 years; P < 0.001) and had higher rates of previous urinary tract infections (UTIs) (56.5% versus 24.5%; P < 0.001) and previous antibiotic use (56.8% versus 22.8%; P < 0.001). Escherichia coli was more frequently isolated from patients with CA-APN than from patients with HCA-APN (79.9% versus 50.5%; P < 0.001). The rates of resistance of Escherichia coli strains from CA-APN patients versus HCA-APN patients were as follows: amoxicillin-clavulanic acid, 22.4% versus 53.2% (P = 0.001); cefuroxime, 7.7% versus 43.5% (P = 0.001); cefotaxime, 4.3% versus 32.6% (P < 0.001); ciprofloxacin, 22.8% versus 74.5% (P < 0.001); and co-trimoxazole, 34.5% versus 58.7% (P = 0.003). The site of acquisition, recurrent UTIs, and previous antibiotic use were independent risk factors for antimicrobial resistance. Relapse rates were significantly higher when definitive antimicrobial treatment was not adequate (37.1% versus 9.3% when definitive antimicrobial treatment was adequate; P < 0.001). Our study reflects the rise of resistance to commonly used antibiotics in acute pyelonephritis. In order to choose the adequate empirical antibiotic therapy, risk factors for resistance should be considered. |*Drug Resistance, Bacterial [MESH] |Acute Disease [MESH] |Adult [MESH] |Aged [MESH] |Amoxicillin-Potassium Clavulanate Combination/therapeutic use [MESH] |Anti-Bacterial Agents/*therapeutic use [MESH] |Cefotaxime/therapeutic use [MESH] |Cefuroxime/therapeutic use [MESH] |Ciprofloxacin/therapeutic use [MESH] |Cohort Studies [MESH] |Community-Acquired Infections [MESH] |Cross Infection/*drug therapy/microbiology/pathology [MESH] |Empirical Research [MESH] |Escherichia coli Infections/*drug therapy/microbiology/pathology [MESH] |Escherichia coli/*drug effects/growth & development [MESH] |Female [MESH] |Hospitals, University [MESH] |Humans [MESH] |Logistic Models [MESH] |Male [MESH] |Microbial Sensitivity Tests [MESH] |Middle Aged [MESH] |Pyelonephritis/*drug therapy/microbiology/pathology [MESH] |Risk Factors [MESH] |Spain [MESH] |Trimethoprim, Sulfamethoxazole Drug Combination/therapeutic use [MESH]A Cohort Study of Risk Factors That Influence Empirical Treatment of P(epmc).pdf DeepDyve Pubget Overpricing