title: Community-acquired urinary tract infection in adults: a hospital viewpoint.
abstract: The clinical and epidemiologic spectrum of 175 cases of community-acquired urinary tract infection (UTI) were evaluated at a university hospital. Patients were grouped in five different categories of which complicated UTI was the most common (39%). Bacteraemia was detected in eight patients (18%) of this group and in five (12%) with acute uncomplicated pyelonephritis. A single organism was isolated in 166 cases (95%). The rate of Escherichia coli bacteriuria ranged from 60% (asymptomatic bacteriuria) to 94% (uncomplicated cystitis). Of the 184 isolates, 92% were susceptible to ciprofloxacin and significantly high rates of resistance were found for ampicillin, cefazolin, cefuroxime, and co-trimoxazole. Isolates causing uncomplicated UTI had significantly high rates of resistance to ampicillin, amoxycillin-clavulanate and co-trimoxazole and those causing complicated UTI, had significantly high rates of resistance to most oral antibiotics tested, except quinolones and nitrofurantoine. Community-acquired UTI requiring hospital evaluation occurs in a complex group of patients, and current patterns of antibiotic resistance make it difficult to suggest empiric oral treatments in this setting.
authors.affiliation: Department of Internal Medicine, Rambam Medical Center, Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
authors.forename: R
authors.initials: R
authors.lastname: Finkelstein
authors.forename: E
authors.initials: E
authors.lastname: Kassis
authors.forename: G
authors.initials: G
authors.lastname: Reinhertz
authors.forename: S
authors.initials: S
authors.lastname: Gorenstein
authors.forename: P
authors.initials: P
authors.lastname: Herman
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017714:Community-Acquired Infections / Q000188:drug therapy / Q000382:microbiology*; D003556:Cystitis / Q000188:drug therapy / Q000382:microbiology*; D004352:Drug Resistance, Microbial; D005260:Female; D006785:Hospitals, University; D006801:Humans; D017053:Infection Control; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D011704:Pyelonephritis / Q000188:drug therapy / Q000382:microbiology*