1686. Microbiology of Community-Onset Urinary Tract Infections in the United States, 2012-2017

Details

• Alternative Title:
  Open Forum Infect Dis
• Personal Author:
  Preston, Leigh Ellyn ; McDonald, Clifford ; Olubajo, Babatunde ; McCarthy, Natalie ; Reddy, Sujan ; Wolford, Hannah ; Hatfield, Kelly M ; Sheriff, Edward ; Jernigan, John A ; Kourtis, Athena P ; Baggs, James
• Description:
  Background
  
  Community-onset urinary tract infections (coUTIs) are one of the most common indications for antibiotic prescribing. It is important to understand patient demographic factors associated with microorganisms causing coUTI and their antibiotic resistance profiles, to tailor antibiotic prescribing practices. We analyzed microbiology data to understand factors associated with coUTI in the United States (US).
  
  Methods
  
  CoUTIs were identified in the Premier Healthcare Database and Cerner Health Facts among patients treated at participating healthcare facilities in the US between 2012-2017. Cases were defined by urine cultures yielding a bacterial organism and were collected in outpatient settings or within three days of hospitalization. Only the first specimen for each encounter was included in the analysis. Data on the organisms isolated, patient’s age, sex, and US census regions of the submitting facilities were described and compared using chi-square tests for associations. Encounters were classified as inpatient (INPT), observation (OBS), emergency department (ED), and outpatient (OTPT) based on the setting in which the culture was submitted.
  
  Results
  
  Using data from 637 acute care hospitals, urine samples from 3,291,561 encounters were included, with 776,653 (25.7%) INPT, 1,063,219 (34.8%) ED, 107,760 (3.5%) OBS, and 1,092,658 (35.8%) OTPT. The pathogens most frequently associated with coUTIs were Escherichia coli (57.3%), Klebsiella pneumoniae (9.7%), Enterococcus faecalis (5.1%), Proteus mirabilis (4.9%), and Pseudomonas aeruginosa (2.9%). Female sex, age < 65y and OTPT and ED settings were associated with higher relative frequency of E. coli (all p < 0.0001). Male sex, INPT setting and age >65 y were associated with higher relative frequency of P. aeruginosa, P. mirabilis and E. faecalis (all p < 0.0001, Figure). K. pneumoniae was found at higher relative frequency in those >45y, and in INPT and OBS settings (all p < 0.0001).
  
  Conclusion
  
  Understanding patient factors associated with the microbiology of coUTIs is an important step in developing treatment recommendations and antibiotic stewardship efforts. Further analyses will include assessing the impact of major antibiotic resistance phenotypes, geographic and healthcare settings.
  
  Disclosures
  
  All Authors: No reported disclosures
  
  
• Subjects:
  AcademicSubjects/MED00290 Poster Abstracts
• Source:
  Open Forum Infect Dis. 2020; 7(Suppl 1):S826-S827
• Pubmed Central ID:
  PMC7778278
• Document Type:
  Journal Article
• Volume:
  7
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:618c453ee17173fb407da1f759bf5a677fe87728d6da0b8a16a18a9dc5590901
• Download URL:
  https://stacks.cdc.gov/view/cdc/111628/cdc_111628_DS1.pdf
• File Type:
  [PDF - 673.26 KB ]