Clinical Impact of Fluoroquinolone Resistance in Bacteremia Caused by Gram-Negative Bacilli of Urinary Tract Origin



Status:Completed
Conditions:Infectious Disease, Hematology, Urology, Urinary Tract Infections
Therapuetic Areas:Hematology, Immunology / Infectious Diseases, Nephrology / Urology, Other
Healthy:No
Age Range:18 - Any
Updated:6/14/2018
Start Date:February 2007
End Date:June 2017

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The information collected will optimize the management of patients with urinary tract
infections with secondary bacteremia, primarily with gram negative bacteria especially
Escherichia coli. The current IDSA guideline endorses the use of fluoroquinolones and
trimethoprim-sulfamethoxazole as the first line agents. However, over use of this empiric
regimen could result in in appropriate treatment of bacteremia.

The following information will be collected: age, sex, occupation, hospital location at the
time of positive culture (ER, medical ward, ICU etc), prior hospitalization, receipt of
outpatient dialysis, home care or other regular medical care (eg, outpatient chemotherapy),
presence of invasive devices, receipt of antibiotics, including their type and whether they
were adequate for the resistance profile of the organism, prior positive microbiologic
cultures, time and location of positive cultures, underlying diseases and severity of
illness, presence of urinary or intravascular devices, recent immunomodulative therapies or
radiation therapy, physical exam findings, laboratory and radiographical data, antimicrobial
usage within 30 days of onset of the infection, microbiological data and resistance patterns,
choice of antibiotics once organism identified, bacteriological outcomes, laboratory results,
demographic information, medications, clinical outcome,gender, height, weight, ethnicity, and
past medical history. We will collect information retrospectively.

Inclusion Criteria:

- Clinical information is collected by chart review of "case" and "control" patients. A
"case" patient is defined as follows:

- One or more blood cultures are positive for Gram-negative bacteria.

- The same organism is recovered in urine culture within a 48-hour period.

- The organism is ciprofloxacin resistant.

- A "control" patient is defined as follows:

- One or more blood cultures are positive for Gram-negative bacteria.

- The same organism is recovered in urine culture within a 48-hour period.

- The organism is ciprofloxacin susceptible.

Exclusion Criteria:

- negative culture
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