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Can urinary nitrites or other urinalysis findings be a predictor of bacterial resistance of uncomplicated urinary tract infections?

BACKGROUND AND OBJECTIVES: To evaluate whether initial urinalysis (UA) and urinary nitrite results can be used as a proxy for choosing empiric antibiotic therapy. MATERIALS AND METHODS: A retrospective study was conducted in an urban inner city community hospital in New York City (NYU Woodhull Medic...

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Autores principales: Medows, Marsha, Nijres, Bassel Mohammad, Elbakoush, Faesal, Alali, Abdulrazak, Patel, Rifali, Mohammad, Sami
Formato: Online Artículo Texto
Lenguaje:English
Publicado: King Faisal Specialist Hospital and Research Centre 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6372408/
https://www.ncbi.nlm.nih.gov/pubmed/30805462
http://dx.doi.org/10.1016/j.ijpam.2016.01.001
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author Medows, Marsha
Nijres, Bassel Mohammad
Elbakoush, Faesal
Alali, Abdulrazak
Patel, Rifali
Mohammad, Sami
author_facet Medows, Marsha
Nijres, Bassel Mohammad
Elbakoush, Faesal
Alali, Abdulrazak
Patel, Rifali
Mohammad, Sami
author_sort Medows, Marsha
collection PubMed
description BACKGROUND AND OBJECTIVES: To evaluate whether initial urinalysis (UA) and urinary nitrite results can be used as a proxy for choosing empiric antibiotic therapy. MATERIALS AND METHODS: A retrospective study was conducted in an urban inner city community hospital in New York City (NYU Woodhull Medical Center). We reviewed the charts of patients seen in the Emergency Department and Pediatric Clinic who had a diagnosis of urinary tract infection (UTI) during a 3 year time period (January 2010–December 2012). Statistical analysis was performed using SPSS 20.0 statistical software. RESULTS: Between January 2010 and December 2012, a total of 378 patients had a diagnosis of UTI. Seventy-five (19.8%) were males and 203 (80.2%) were females. Of the 378 patients with a diagnosis of UTI, the most common isolated pathogen was Escherichia coli, which was detected in 283 (74.9%) isolates. Other bacteria included Klebsiella spp 30 (7.9%), Proteus 21 (5.6%), Enterococcus 14 (3.7%), and others 30 (7.9%). The resistance rate was higher in the nitrite positive group for the following antibiotics: TMP/SMX and ampicillin with or without sulbactam. No significant correlation was found with the remaining studied antibiotics. No significant correlation was found between leukoesterase and the resistance patterns in all of the studied antibiotics, except cefazolin. CONCLUSION: Urinary nitrite results are not helpful in choosing an initial antibiotic to treat a UTI. Leukocytosis in the blood or urine or the presence of a fever cannot be used to predict bacterial resistance. The use of nitrofurantoin or cephalexin for the treatment of cystitis was optimum, and in the presence of negative leukoesterase, nitrofurantoin was preferable to cephalexin.
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spelling pubmed-63724082019-02-25 Can urinary nitrites or other urinalysis findings be a predictor of bacterial resistance of uncomplicated urinary tract infections? Medows, Marsha Nijres, Bassel Mohammad Elbakoush, Faesal Alali, Abdulrazak Patel, Rifali Mohammad, Sami Int J Pediatr Adolesc Med Original Research Article BACKGROUND AND OBJECTIVES: To evaluate whether initial urinalysis (UA) and urinary nitrite results can be used as a proxy for choosing empiric antibiotic therapy. MATERIALS AND METHODS: A retrospective study was conducted in an urban inner city community hospital in New York City (NYU Woodhull Medical Center). We reviewed the charts of patients seen in the Emergency Department and Pediatric Clinic who had a diagnosis of urinary tract infection (UTI) during a 3 year time period (January 2010–December 2012). Statistical analysis was performed using SPSS 20.0 statistical software. RESULTS: Between January 2010 and December 2012, a total of 378 patients had a diagnosis of UTI. Seventy-five (19.8%) were males and 203 (80.2%) were females. Of the 378 patients with a diagnosis of UTI, the most common isolated pathogen was Escherichia coli, which was detected in 283 (74.9%) isolates. Other bacteria included Klebsiella spp 30 (7.9%), Proteus 21 (5.6%), Enterococcus 14 (3.7%), and others 30 (7.9%). The resistance rate was higher in the nitrite positive group for the following antibiotics: TMP/SMX and ampicillin with or without sulbactam. No significant correlation was found with the remaining studied antibiotics. No significant correlation was found between leukoesterase and the resistance patterns in all of the studied antibiotics, except cefazolin. CONCLUSION: Urinary nitrite results are not helpful in choosing an initial antibiotic to treat a UTI. Leukocytosis in the blood or urine or the presence of a fever cannot be used to predict bacterial resistance. The use of nitrofurantoin or cephalexin for the treatment of cystitis was optimum, and in the presence of negative leukoesterase, nitrofurantoin was preferable to cephalexin. King Faisal Specialist Hospital and Research Centre 2016-03 2016-03-04 /pmc/articles/PMC6372408/ /pubmed/30805462 http://dx.doi.org/10.1016/j.ijpam.2016.01.001 Text en Copyright © 2016, King Faisal Specialist Hospital & Research Centre (General Organization), Saudi Arabia. Production and hosting. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Research Article
Medows, Marsha
Nijres, Bassel Mohammad
Elbakoush, Faesal
Alali, Abdulrazak
Patel, Rifali
Mohammad, Sami
Can urinary nitrites or other urinalysis findings be a predictor of bacterial resistance of uncomplicated urinary tract infections?
title Can urinary nitrites or other urinalysis findings be a predictor of bacterial resistance of uncomplicated urinary tract infections?
title_full Can urinary nitrites or other urinalysis findings be a predictor of bacterial resistance of uncomplicated urinary tract infections?
title_fullStr Can urinary nitrites or other urinalysis findings be a predictor of bacterial resistance of uncomplicated urinary tract infections?
title_full_unstemmed Can urinary nitrites or other urinalysis findings be a predictor of bacterial resistance of uncomplicated urinary tract infections?
title_short Can urinary nitrites or other urinalysis findings be a predictor of bacterial resistance of uncomplicated urinary tract infections?
title_sort can urinary nitrites or other urinalysis findings be a predictor of bacterial resistance of uncomplicated urinary tract infections?
topic Original Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6372408/
https://www.ncbi.nlm.nih.gov/pubmed/30805462
http://dx.doi.org/10.1016/j.ijpam.2016.01.001
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