title: Antimicrobial susceptibility patterns among Escherichia coli urinary isolates from community-onset health care-associated urinary tract infection.
abstract: Urinary tract infection (UTI) is traditionally classified as community-acquired (CA) and hospital-acquired (HA). Community-onset health care-associated (HCA) infection is a new category that has gained increasing attention. The study aimed to compare the disk susceptibility of nonrepetitive Escherichia coli urinary isolates from HCA-UTI (n = 100) with that of E. coli isolates from CA-UTI (n = 85) and HA-UTI (n = 106). We found that the susceptibility pattern of HCA-UTI E. coli isolates was similar to that of HA-UTI E. coli isolates, but significantly different from that of CA-UTI E. coli isolates. In particular, the proportion of extended-spectrum β-lactamase-producing isolates was significantly higher in HCA-UTI than that in CA-UTI (30.0% vs. 3.5%, p < 0.001). We recommend that when treating HCA-UTI, it is necessary to take urine cultures for susceptibility testing to guide definite antibiotic therapy.
authors.affiliation: Department of Nephrology, Tainan Municipal Hospital, Tainan, Taiwan; Department of Internal Medicine, Tainan Municipal Hospital, Tainan, Taiwan.
authors.forename: Ling-Fu
authors.initials: LF
authors.lastname: Huang
authors.affiliation: Committee of Infection Control, Tainan Municipal Hospital, Tainan, Taiwan.
authors.forename: Yi-Chu
authors.initials: YC
authors.lastname: Lo
authors.affiliation: Department of Laboratory Medicine, Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Kweishan, Taoyuan, Taiwan. Electronic address: sulinhui@gmail.com.
authors.forename: Lin-Hui
authors.initials: LH
authors.lastname: Su
authors.affiliation: Department of Internal Medicine, Tainan Municipal Hospital, Tainan, Taiwan; Committee of Infection Control, Tainan Municipal Hospital, Tainan, Taiwan. Electronic address: c2609926@yahoo.com.tw.
authors.forename: Chin-Lu
authors.initials: CL
authors.lastname: Chang
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D017714:Community-Acquired Infections / Q000382:microbiology / Q000652:urine; D003428:Cross Infection / Q000382:microbiology*; D052978:Disk Diffusion Antimicrobial Tests; D004926:Escherichia coli / Q000187:drug effects*; D004927:Escherichia coli Infections / Q000382:microbiology*; D006801:Humans; D014552:Urinary Tract Infections / Q000382:microbiology* / Q000652:urine
chemical_list: D000900:Anti-Bacterial Agents
keywords: antimicrobial susceptibility; community-acquired; empirical therapy; health care-associated; hospital-acquired; urinary tract infection