Volume 22, Number 9—September 2016
CME ACTIVITY - Research
Fluoroquinolone-Resistant and Extended-Spectrum β-Lactamase–Producing Escherichia coli Infections in Patients with Pyelonephritis, United States1
, Sukhjit S. Takhar, Anusha Krishnadasan, Fredrick M. Abrahamian, William R. Mower, Gregory J. Moran, and EMERGEncy ID Net Study Group
Table 1
Epidemiologic, clinical, and laboratory characteristics of 521 US emergency department patients with acute uncomplicated and complicated pyelonephritis, July 2013–December 2014*
| Value | |||
|---|---|---|---|
| Total patients, N = 521 |
Uncomplicated, n = 286 |
Complicated, n = 235 |
|
| Age, median y (IQR; range) |
37 (26–52; 18–88) |
30 (23–41; 18–79) |
50 (36–58; 19–88) |
| Symptom duration, median d (IQR; range) |
3.0 (2–5; 0–30) |
3.0 (2–5; 0–30) |
3.0 (2–5; 0–30) |
| Initial ED temperature, °C (IQR; range) |
38.9 (38.4–39.4; 38.0–43.0) |
38.9 (38.4–39.4; 38.0–40.3) |
39.0 (38.4–39.4; 38.0–43.0) |
| Sex | |||
| F | 455 (87.3) | 286 (100.0) | 169 (71.9) |
| M |
66 (12.7) |
0 (0) |
66 (28.1) |
| Race/ethnicity | |||
| White/Hispanic | 372 (71.4) | 191 (66.8) | 181 (77.0) |
| Black | 119 (22.8) | 76 (26.6) | 43 (18.3) |
| Asian/Pacific Islander | 22 (4.2) | 15 (5.2) | 7 (3.0) |
| Other | 18 (3.5) | 11 (3.9) | 7 (3.0) |
| Unknown |
5 (1.0) |
3 (1.0) |
2 (0.9) |
| Hispanic ethnicity | |||
| Yes | 281 (53.9) | 155 (54.2) | 126 (53.6) |
| No | 233 (44.7) | 126 (44.1) | 107 (45.5) |
| Unknown |
7 (1.3) |
5 (1.7) |
2 (0.9) |
| Antimicrobial drugs taken | |||
| Within past 60 d | 125 (24.0) | 49 (17.1) | 76 (32.3) |
| Within past 2 d |
36 (6.9) |
15 (5.2) |
21 (8.9) |
| Healthcare-associated illness† |
74 (14.2) |
18 (6.3) |
56 (23.8) |
| Complicating feature | |||
| Concurrent condition | 131 (25.1) | 0 (0) | 131 (55.7) |
| History of UTA | 116 (22.3) | 0 (0) | 116 (49.4) |
| Current feature |
61 (11.7) |
0 (0) |
61 (26.0) |
| UTIs within past year‡ | |||
| 0 | 334 (64.5) | 196 (68.8) | 138 (59.2) |
| 1 | 86 (16.6) | 46 (16.1) | 40 (17.2) |
| 2 | 428 (8.1) | 23 (8.1) | 19 (8.2) |
| ≥3 |
56 (10.8) |
20 (7.0) |
36 (15.5) |
| Travel outside North America within past 90 d§ |
17/520 (3.3) |
8/286 (2.8) |
9/234 (3.8) |
| Prior UTI caused by fluoroquinolone-resistant E. coli | |||
| Within past year | 16 (3.1) | 4 (1.4) | 12 (5.1) |
| Within past 90 d |
14 (2.7) |
2 (0.7) |
12 (5.1) |
| Prior UTI caused by ceftriaxone-resistant E. coli | |||
| Within past year | 9 (1.7) | 2 (0.7) | 7 (3.0) |
| Within past 90 d |
6 (1.2) |
1 (0.3) |
5 (2.1) |
| Severity of Illness¶ | |||
| Mild | 66 (12.7) | 34 (11.9) | 32 (13.6) |
| Moderate | 267 (51.2) | 156 (54.5) | 111 (47.2) |
| Severe |
188 (36.1) |
96 (33.6) |
92 (39.1) |
| Disposition | |||
| Ward | 240 (46.1) | 100 (35.0) | 140 (59.6) |
| MCA | 40 (7.7) | 13 (4.5) | 27 (11.5) |
| Home | 239 (45.9) | 172 (60.1) | 67 (28.5) |
| AMA | 2 (0.4) | 1 (0.3) | 1 (0.4) |
*Values are given as no. (%) except as indicated. AMA, left against medical advice; E. coli , Escherichia coli; ED, emergency department; IQR, interquartile range; MCA, monitored care admission; UTA, urinary tract abnormality; UTI, urinary tract infection..
†Hospitalized or residing in a long-term care facility within past 90 days.
‡Percentages were calculated with UTI information available for 518 patients, 285 of whom had uncomplicated cases and 233 had complicated cases.
§Percentages were calculated with information available for 520 patients, 286 of whom had uncomplicated cases and 234 had complicated cases.
¶Mild indicates illness that does not affect patient’s normal activities; moderate partially affects normal activities but does not confine patient to house or bed; severe affects activities considerably, such as confining patient to house or bed.
1Preliminary results of this research were presented at the 2014 IDWeek Meeting, Philadelphia, PA, USA, October 8–12, 2014.