Recommendations for the Empirical Treatment of Complicated Urinary Tract Infections Using Surveillance Data on Antimicrobial Resistance in the Netherlands: e86634

• Published in: PloS one 2014-01, Vol.9 (1)
• Main Authors: Koningstein, Maike, Bij, K vander, Kraker, E Ade, Monen, Jos C, Muilwijk, Jan, Greeff, Sabine Cde, Geerlings, Suzanne E, Hall, A Leverstein-van
• Format: Article
• Language: English
• Subjects: Enterococcus; Escherichia coli; Klebsiella pneumoniae; Proteus mirabilis
• ISSN: 1932-6203
• DOI: 10.1371/journal.pone.0086634

Background Complicated urinary tract infections (c-UTIs) are among the most common nosocomial infections and a substantial part of the antimicrobial agents used in hospitals is for the treatment of c-UTIs. Data from surveillance can be used to guide the empirical treatment choices of clinicians when treating c-UTIs. We therefore used nation-wide surveillance data to evaluate antimicrobial coverage of agents for the treatment of c-UTI in the Netherlands. Methods We included the first isolate per patient of urine samples of hospitalised patients collected by the Infectious Disease Surveillance Information System for Antibiotic Resistance (ISIS-AR) in 2012, and determined the probability of inadequate coverage for antimicrobial agents based on species distribution and susceptibility. Analyses were repeated for various patient groups and hospital settings. Results The most prevalent bacteria in 27,922 isolates of 23,357 patients were Escherichia coli (47%), Enterococcus spp. (14%), Proteus mirabilis (8%), and Klebsiella pneumoniae (7%). For all species combined, the probability of inadequate coverage was