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A Prediction Tool for the Presence of Ceftriaxone-Resistant Uropathogens upon Hospital Admission

Antimicrobial resistance among uropathogens is a particularly pressing problem in the Asia-Pacific region. The objectives of this study were to determine the incidence and susceptibility of uropathogens upon hospital admission and to develop a risk-scoring model to predict the presence of ceftriaxon...

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Autores principales: Li, Nancy Yanzhe, Poh, Gang Quan, Teng, Gladys Chung Wei, Chen, Hui Hiong, Chan, Douglas Su Gin, Chan, Siew-Pang, Tambyah, Paul Anantharajah, Bagdasarian, Natasha, Wu, Jia En
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7345845/
https://www.ncbi.nlm.nih.gov/pubmed/32531880
http://dx.doi.org/10.3390/antibiotics9060316
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author Li, Nancy Yanzhe
Poh, Gang Quan
Teng, Gladys Chung Wei
Chen, Hui Hiong
Chan, Douglas Su Gin
Chan, Siew-Pang
Tambyah, Paul Anantharajah
Bagdasarian, Natasha
Wu, Jia En
author_facet Li, Nancy Yanzhe
Poh, Gang Quan
Teng, Gladys Chung Wei
Chen, Hui Hiong
Chan, Douglas Su Gin
Chan, Siew-Pang
Tambyah, Paul Anantharajah
Bagdasarian, Natasha
Wu, Jia En
author_sort Li, Nancy Yanzhe
collection PubMed
description Antimicrobial resistance among uropathogens is a particularly pressing problem in the Asia-Pacific region. The objectives of this study were to determine the incidence and susceptibility of uropathogens upon hospital admission and to develop a risk-scoring model to predict the presence of ceftriaxone-resistance uropathogens (CrP). This was a retrospective observational cohort study of patients with a positive urine culture within 48 h of presentation at National University Hospital, Singapore between June 2015 and August 2015. Escherichia coli was the most common uropathogen isolated (51.7%), followed by Klebsiella pneumonia (15.1%) and Pseudomonas aeruginosa (8.2%). Overall, 372 out of 869 isolates (42.8%) were resistant to ceftriaxone. Hospitalization for ≥2 days within past 30 days, antibiotic use within the past 3 months and male gender were associated with the presence of CrP. A risk score based on these parameters successfully predicted CrP with an area under the curve of 0.68. The risk score will help clinicians to accurately predict antibiotic resistance at the individual patient level and allow physicians to safely prescribe empiric ceftriaxone in patients at low risk of CrP, thus reducing the antibiotic selection pressure that is driving carbapenem resistance in hospitals throughout Asia.
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spelling pubmed-73458452020-07-09 A Prediction Tool for the Presence of Ceftriaxone-Resistant Uropathogens upon Hospital Admission Li, Nancy Yanzhe Poh, Gang Quan Teng, Gladys Chung Wei Chen, Hui Hiong Chan, Douglas Su Gin Chan, Siew-Pang Tambyah, Paul Anantharajah Bagdasarian, Natasha Wu, Jia En Antibiotics (Basel) Article Antimicrobial resistance among uropathogens is a particularly pressing problem in the Asia-Pacific region. The objectives of this study were to determine the incidence and susceptibility of uropathogens upon hospital admission and to develop a risk-scoring model to predict the presence of ceftriaxone-resistance uropathogens (CrP). This was a retrospective observational cohort study of patients with a positive urine culture within 48 h of presentation at National University Hospital, Singapore between June 2015 and August 2015. Escherichia coli was the most common uropathogen isolated (51.7%), followed by Klebsiella pneumonia (15.1%) and Pseudomonas aeruginosa (8.2%). Overall, 372 out of 869 isolates (42.8%) were resistant to ceftriaxone. Hospitalization for ≥2 days within past 30 days, antibiotic use within the past 3 months and male gender were associated with the presence of CrP. A risk score based on these parameters successfully predicted CrP with an area under the curve of 0.68. The risk score will help clinicians to accurately predict antibiotic resistance at the individual patient level and allow physicians to safely prescribe empiric ceftriaxone in patients at low risk of CrP, thus reducing the antibiotic selection pressure that is driving carbapenem resistance in hospitals throughout Asia. MDPI 2020-06-10 /pmc/articles/PMC7345845/ /pubmed/32531880 http://dx.doi.org/10.3390/antibiotics9060316 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Li, Nancy Yanzhe
Poh, Gang Quan
Teng, Gladys Chung Wei
Chen, Hui Hiong
Chan, Douglas Su Gin
Chan, Siew-Pang
Tambyah, Paul Anantharajah
Bagdasarian, Natasha
Wu, Jia En
A Prediction Tool for the Presence of Ceftriaxone-Resistant Uropathogens upon Hospital Admission
title A Prediction Tool for the Presence of Ceftriaxone-Resistant Uropathogens upon Hospital Admission
title_full A Prediction Tool for the Presence of Ceftriaxone-Resistant Uropathogens upon Hospital Admission
title_fullStr A Prediction Tool for the Presence of Ceftriaxone-Resistant Uropathogens upon Hospital Admission
title_full_unstemmed A Prediction Tool for the Presence of Ceftriaxone-Resistant Uropathogens upon Hospital Admission
title_short A Prediction Tool for the Presence of Ceftriaxone-Resistant Uropathogens upon Hospital Admission
title_sort prediction tool for the presence of ceftriaxone-resistant uropathogens upon hospital admission
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7345845/
https://www.ncbi.nlm.nih.gov/pubmed/32531880
http://dx.doi.org/10.3390/antibiotics9060316
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