title: Clinical Characteristics and Antimicrobial Susceptibility Pattern of Hospitalized Patients with Community Acquired Urinary Tract Infections at a Regional Hospital in Taiwan.
abstract: BACKGROUND
  Community-acquired urinary tract infection (UTI) is the most common bacterial infection encountered at hospitals. Effective empirical antibiotic therapy relies on updated epidemiological data.
  
  
  OBJECTIVE
  We described the epidemiology of patients with urosepsis presenting to a community hospital in Taiwan in order to assess the appropriateness of empirical therapy.
  
  
  METHODS
  Retrospective cohort study of hospitalized adult patients with UTI from January 1 to December 31 in 2010. The clinical and microbiological characteristics were analyzed using descriptive statistics. Logistic regression analysis was performed to determine predictors of antibiotic resistance.
  
  
  RESULTS
  A total of 420 consecutive patients with 599 isolates were identified. Most patients were >=65 years old and women (75.4%), and 114 patients (27.1%) had bacteremia.Escherichia coli(69%) was the most common organism. Cefazolin was effective againstE. coli, K. pneumoniae, andP. mirabilisin greater than 80% of the cases. In male patients, urinary catheter and renal stone were independent predictors for cefazolin resistance; while diabetes mellitus and malignancy were predictors among female patients.
  
  
  CONCLUSIONS
  Patients admitted with UTI should be screened to identify risk factors for bacteremia and antimicrobial resistance. The treatment guideline in Taiwan needs to be revised in the current era of increasing antimicrobial resistance.
authors.affiliation: Program for Infection Prevention and Healthcare Epidemiology, Division of Infectious Diseases and International Health, Department of Medicine, Duke University Medical Center, Durham, North Carolina, 27710, USA.
authors.forename: Luke F
authors.initials: LF
authors.lastname: Chen
authors.affiliation: Medical Clinic at Taoyuan International Airport, Landseed Hospital, Taiwan.
authors.forename: Chun-Ting
authors.initials: CT
authors.lastname: Chiu
authors.affiliation: Center of Infection Control, Landseed Hospital, Taiwan.
authors.forename: Jui-Yo
authors.initials: JY
authors.lastname: Lo
authors.affiliation: Center of Infection Control, Landseed Hospital, Taiwan.
authors.forename: Si-Yuan
authors.initials: SY
authors.lastname: Tsai
authors.affiliation: Department of Pathology and Laboratory, Landseed Hospital, Taiwan.
authors.forename: Li-Shiu
authors.initials: LS
authors.lastname: Weng
authors.affiliation: Program for Infection Prevention and Healthcare Epidemiology, Division of Infectious Diseases and International Health, Department of Medicine, Duke University Medical Center, Durham, North Carolina, 27710, USA.
authors.forename: Deverick J
authors.initials: DJ
authors.lastname: Anderson
authors.affiliation: Center of Infection Control, Landseed Hospital, Taiwan ; Division of Infectious Diseases, Department of Internal Medicine, Landseed Hospital, Taiwan.
authors.forename: Huan-Sheng
authors.initials: HS
authors.lastname: Chen
keywords: Antimicrobial resistance; Community Hospitals; Epidemiology; Guidelines; Urinary tract infection