Community-Associated Uropathogen Antimicrobial Resistance Among Emergency Department Patients With Acute Pyelonephritis
| Status: | Completed |
|---|---|
| Conditions: | Hospital, Nephrology |
| Therapuetic Areas: | Nephrology / Urology, Other |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 4/13/2015 |
| Start Date: | July 2013 |
| End Date: | December 2014 |
| Contact: | Anusha Krishnadasan, PhD |
| Email: | idnet@ucla.edu |
| Phone: | 818-364-3111 |
Surveillance and Risk Factor Analysis of Community-Associated Uropathogen Antimicrobial Resistance Among Emergency Department Patients With Acute Pyelonephritis in the United States
Pyelonephritis is a serious infection that manifests with fever, back pain, nausea, and
vomiting. In the U.S., it is estimated that there are 20 cases of pyelonephritis per 10,000
annually, with the highest incidence in young women. Escherichia coli (E. coli) causes over
80% of these infections. Over the last two decades, E. coli resistance has emerged to
commonly prescribed antimicrobials, such as ampicillin and trimethoprim-sulfamethoxazole
(TMP/SMX). Most recently, resistance to fluoroquinolones and strains producing
extended-spectrum beta-lactamases (ESBL) have been observed. In order to better understand
the evolution and current state of antibiotic resistance among E. coli urinary tract
isolates so as to better inform treatment decisions, the investigators propose to conduct an
investigation to: a) determine the prevalence of antimicrobial resistance among E. coli
causing acute pyelonephritis in various patient groups, and specifically healthy
community-dwellers with uncomplicated infections, b) determine the specific prevalence of
fluoroquinolone-resistance and ESBL-producing E. coli, and c) determine potential risk
factors for fluoroquinolone and ESBL-producing E. coli infections.
vomiting. In the U.S., it is estimated that there are 20 cases of pyelonephritis per 10,000
annually, with the highest incidence in young women. Escherichia coli (E. coli) causes over
80% of these infections. Over the last two decades, E. coli resistance has emerged to
commonly prescribed antimicrobials, such as ampicillin and trimethoprim-sulfamethoxazole
(TMP/SMX). Most recently, resistance to fluoroquinolones and strains producing
extended-spectrum beta-lactamases (ESBL) have been observed. In order to better understand
the evolution and current state of antibiotic resistance among E. coli urinary tract
isolates so as to better inform treatment decisions, the investigators propose to conduct an
investigation to: a) determine the prevalence of antimicrobial resistance among E. coli
causing acute pyelonephritis in various patient groups, and specifically healthy
community-dwellers with uncomplicated infections, b) determine the specific prevalence of
fluoroquinolone-resistance and ESBL-producing E. coli, and c) determine potential risk
factors for fluoroquinolone and ESBL-producing E. coli infections.
Inclusion Criteria:
- patients > 18 years of age with flank pain and/or costovertebral angle tenderness
- documented temperature in the emergency department of ≥38°C/100.4°F by any method of
measurement,
- documented temperature in the emergency department of ≥38°C/100.4°F by any method of
measurement,
Exclusion Criteria:
- complicated pyelonephritis
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