1697. The Burden Of Multidrug-Resistant Urinary Tract Infections

BACKGROUND: Urinary tract infections (UTIs) are the most common reason for consultation and for antibiotic use. Many factors interfere and increase the risk for antimicrobial resistance. We aimed to study the clinical, laboratory and evolutionary particularities associated with multidrug-resistant (MDR) UTIs. METHODS: We conducted a retrospective study including all patients hospitalized for UTIs in the infectious diseases department between 2011 and 2018. RESULTS: A total of 867 cases of UTIs were included in the study, among which 407 cases (46.9%) were MDR. There were 306 males (35.3%). The mean age was 53±21 years. Overall, MRD UTIs were significantly associated to male gender (39.1% vs 32%; p=0.02). Patients aged ≥65 years were significantly more affected with MRD UTIs (54.5% vs 36.5%; p< 0.001). Previous medical history of diabetes (38.1% vs 24.6%; p< 0.001), antibiotic consumption (30.7% vs 13%; p< 0.001) and surgical intervention of the urinary tract (13% vs 5.4%; p< 0.001) were significantly associated with MDR UTIs. The mean delay to hospitalization was significantly longer among MDR UTIs cases (5[3-10 days] vs 3[2-7 days]; p< 0.001). In total, MDR UTIs were more frequently documented to Klebsiella pneumoniae (19.4% vs 12%; p=0.002). Comparison of the disease evolution showed that MRD UTIs were significantly associated with complications (9.1% vs 5.2%; p=0.02), recurrence (4.4% vs 1.5%; p=0.01) and death (2.2% vs 0.4%; p=0.02). As to laboratory investigations and antibiotic duration, no significant difference was noted. CONCLUSION: Our study showed that MDR UTIs were associated with not only complications, but also with a poor prognosis. The continuous surveillance for antimicrobial resistance and the rational use of antibiotics are crucial in order to improve the prognosis. DISCLOSURES: All Authors: No reported disclosures