Abstracts of the 2023 Annual Meeting of the ALEH
Más datosNo
Introduction and ObjectivesThe lack of data on bacterial susceptibility in urinary tract infections (UTI) among patients complicates empirical antibiotic selection. Aims: To assess the antibiotic susceptibility of UTI-causing bacteria in patients with cirrhosis and recommend appropriate antibiotic therapy.
Patients / Materials and MethodsCross-sectional study using data from the prospective registry of bacterial infections in adult patients with cirrhosis in Argentina and Uruguay. We included episodes of culture-positive UTI in patients hospitalized for this condition or who developed a UTI during their stay. Antibiotic susceptibility patterns and recommendations are presented according to the site of acquisition. According to our definition, empirical antibiotic treatment should aim to cover roughly 80% of anticipated bacteria in stable patients and 90% in critically-ill patients.
Results and DiscussionA total of 278 episodes were included, involving 227 patients recruited from 20 centers between Dec/2020 and July/2024. Of these, 97% (n=269) were monobacterial, and 3% (n=9) involved infections with two bacteria, resulting in 287 isolates. The most frequent isolates were enterobacteria, especially E. coli (43%), notably in community-acquired (CA) UTI (60%); K. pneumoniae accounted for 28% of the isolates, rising to 40% in nosocomial UTI. The most frequent Gram-positive cocci was enterococcus (14%). The table displays the susceptibility patterns for various antibiotics and highlights those suitable for empirical treatment according to the observed coverage. Multidrug resistance was observed in 52% (CI95: 46-58) of episodes: 40% (CI95: 32-50) in community-acquired and 68% (CI95: 57-77) in nosocomial infections. It is concerning that half of UTI are caused by multidrug-resistant organisms, and that only combinations of broad-spectrum antibiotics offer adequate coverage for nosocomial infections.
ConclusionsFor the first time in Latin America, we provide high-quality data to guide empirical antibiotic recommendations for UTI in patients with cirrhosis.
