Published In
Open Forum Infectious Diseases
Document Type
Article
Publication Date
8-2023
Subjects
Multidrug antibiotic resistance, Urinary tract infection
Abstract
Background
Urinary tract infections (UTIs) cause significant disease and economic burden. Uncomplicated UTIs (uUTIs) occur in otherwise healthy individuals without underlying structural abnormalities, with uropathogenic Escherichia coli (UPEC) accounting for 80% of cases. With recent transitions in healthcare toward virtual visits, data on multidrug resistance (MDR) (resistant to ≥3 antibiotic classes) by care setting are needed to inform empiric treatment decision making.
Methods
We evaluated UPEC resistance over time by care setting (in-person vs virtual), in adults who received outpatient care for uUTI at Kaiser Permanente Southern California between January 2016 and December 2021.
Results
We included 174 185 individuals who had ≥1 UPEC uUTI (233 974 isolates) (92% female, 46% Hispanic, mean age 52 years [standard deviation 20]). Overall, prevalence of UPEC MDR decreased during the study period (13% to 12%) both in virtual and in-person settings (P for trendConclusions
We observed a slight decrease in both class-specific antimicrobial resistance and MDR of UPEC overall, most commonly involving penicillins and TMP-SMX. Resistance patterns were consistent over time and similar in both in-person and virtual settings. Virtual healthcare may expand access to UTI care.
Rights
Copyright (c) 2023 The Authors
This work is licensed under a Creative Commons Attribution 4.0 International License.
Locate the Document
DOI
10.1093/ofid/ofad287
Persistent Identifier
https://archives.pdx.edu/ds/psu/40649
Citation Details
Ku, J. H., Bruxvoort, K. J., Salas, S. B., Varley, C. D., Casey, J. A., Raphael, E., ... & Tartof, S. Y. (2023, May). Multi-drug resistance of Escherichia coli from outpatient uncomplicated urinary tract infections in a large US integrated health care organization. In Open Forum Infectious Diseases (p. ofad287). Oxford University Press.