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Empiric Usage of “Anti-Pseudomonal” Agents for Hospital-Acquired Urinary Tract Infections

Hospital-acquired urinary tract infection (HAUTI) is one of the most common hospital-acquired infections, and over 80% of HAUTI are catheter-associated (CAUTI). Pseudomonas aeruginosa, as well as other non-glucose fermenting Gram negative organisms (NGFGN, e.g., Acinetobacter baumannii), are frequen...

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Autores principales: Rahat, Ori, Shihab, Murad, Etedgi, Elhai, Ben-David, Debby, Estrin, Inna, Goldshtein, Lili, Zilberman-Itskovich, Shani, Marchaim, Dror
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9312097/
https://www.ncbi.nlm.nih.gov/pubmed/35884144
http://dx.doi.org/10.3390/antibiotics11070890
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author Rahat, Ori
Shihab, Murad
Etedgi, Elhai
Ben-David, Debby
Estrin, Inna
Goldshtein, Lili
Zilberman-Itskovich, Shani
Marchaim, Dror
author_facet Rahat, Ori
Shihab, Murad
Etedgi, Elhai
Ben-David, Debby
Estrin, Inna
Goldshtein, Lili
Zilberman-Itskovich, Shani
Marchaim, Dror
author_sort Rahat, Ori
collection PubMed
description Hospital-acquired urinary tract infection (HAUTI) is one of the most common hospital-acquired infections, and over 80% of HAUTI are catheter-associated (CAUTI). Pseudomonas aeruginosa, as well as other non-glucose fermenting Gram negative organisms (NGFGN, e.g., Acinetobacter baumannii), are frequently covered empirically with “anti-Pseudomonals” being administered for every HAUTI (and CAUTI). However, this common practice was never trialed in controlled settings in order to quantify its efficacy and its potential impacts on hospitalization outcomes. There were 413 patients with HAUTI that were included in this retrospective cohort study (2017–2018), 239 (57.9%) had CAUTI. There were 75 NGFGN infections (18.2% of HAUTI, 22.3% of CAUTI). P. aeruginosa was the most common NGFGN (82%). Despite multiple associations per univariable analysis, recent (3 months) exposure to antibiotics was the only independent predictor for NGFGN HAUTI (OR = 2.4, CI-95% = 1.2–4.8). Patients who received empiric anti-Pseudomonals suffered from worse outcomes, but in multivariable models (one for each outcome), none were independently associated with the empiric administration of anti-Pseudomonals. To conclude, approximately one of every five HAUTI (and CAUTI) are due to NGFGN, which justifies the practice of empiric anti-Pseudomonals for patients with HAUTI (and CAUTI), particularly patients who recently received antibiotics. The practice is not associated with independent deleterious impacts on outcomes.
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spelling pubmed-93120972022-07-26 Empiric Usage of “Anti-Pseudomonal” Agents for Hospital-Acquired Urinary Tract Infections Rahat, Ori Shihab, Murad Etedgi, Elhai Ben-David, Debby Estrin, Inna Goldshtein, Lili Zilberman-Itskovich, Shani Marchaim, Dror Antibiotics (Basel) Article Hospital-acquired urinary tract infection (HAUTI) is one of the most common hospital-acquired infections, and over 80% of HAUTI are catheter-associated (CAUTI). Pseudomonas aeruginosa, as well as other non-glucose fermenting Gram negative organisms (NGFGN, e.g., Acinetobacter baumannii), are frequently covered empirically with “anti-Pseudomonals” being administered for every HAUTI (and CAUTI). However, this common practice was never trialed in controlled settings in order to quantify its efficacy and its potential impacts on hospitalization outcomes. There were 413 patients with HAUTI that were included in this retrospective cohort study (2017–2018), 239 (57.9%) had CAUTI. There were 75 NGFGN infections (18.2% of HAUTI, 22.3% of CAUTI). P. aeruginosa was the most common NGFGN (82%). Despite multiple associations per univariable analysis, recent (3 months) exposure to antibiotics was the only independent predictor for NGFGN HAUTI (OR = 2.4, CI-95% = 1.2–4.8). Patients who received empiric anti-Pseudomonals suffered from worse outcomes, but in multivariable models (one for each outcome), none were independently associated with the empiric administration of anti-Pseudomonals. To conclude, approximately one of every five HAUTI (and CAUTI) are due to NGFGN, which justifies the practice of empiric anti-Pseudomonals for patients with HAUTI (and CAUTI), particularly patients who recently received antibiotics. The practice is not associated with independent deleterious impacts on outcomes. MDPI 2022-07-04 /pmc/articles/PMC9312097/ /pubmed/35884144 http://dx.doi.org/10.3390/antibiotics11070890 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/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 (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Rahat, Ori
Shihab, Murad
Etedgi, Elhai
Ben-David, Debby
Estrin, Inna
Goldshtein, Lili
Zilberman-Itskovich, Shani
Marchaim, Dror
Empiric Usage of “Anti-Pseudomonal” Agents for Hospital-Acquired Urinary Tract Infections
title Empiric Usage of “Anti-Pseudomonal” Agents for Hospital-Acquired Urinary Tract Infections
title_full Empiric Usage of “Anti-Pseudomonal” Agents for Hospital-Acquired Urinary Tract Infections
title_fullStr Empiric Usage of “Anti-Pseudomonal” Agents for Hospital-Acquired Urinary Tract Infections
title_full_unstemmed Empiric Usage of “Anti-Pseudomonal” Agents for Hospital-Acquired Urinary Tract Infections
title_short Empiric Usage of “Anti-Pseudomonal” Agents for Hospital-Acquired Urinary Tract Infections
title_sort empiric usage of “anti-pseudomonal” agents for hospital-acquired urinary tract infections
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9312097/
https://www.ncbi.nlm.nih.gov/pubmed/35884144
http://dx.doi.org/10.3390/antibiotics11070890
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