ArticleThe Journal of antimicrobial chemotherapy2024
Treatment, outcomes and characterization of pathogens in urinary tract infections caused by ESBL-producing Enterobacterales: a prospective multicentre study.
Article in The Journal of antimicrobial chemotherapy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 11 citations in OpenAlex.
- Prevalence and β-Lactam Resistance of Enterobacterales Isolated from Urinary Samples in a Regional Hospital in Poland: Special Emphasis on Elderly Population.Pathogens (Basel, Switzerland) · 2026Article
- Analysis of Human miRNA Derived From Bladder Epithelial Cells Infected With Uropathogenic Escherichia coli.APMIS : acta pathologica, microbiologica, et immunologica Scandinavica · 2026Article
- Virulence factors and outcomes in bacteremia caused by extended-spectrum β-lactamase-producing uropathogenic Escherichia coli ST131-H30Rx in a Swedish county.BMC infectious diseases · 2025Article
- New Perspectives on Antimicrobial Agents: Pivmecillinam.Antimicrobial agents and chemotherapy · 2025Review
- Prevalence, Characterization, and Proteomic Relatedness Among β-Lactam-Resistant Bacteria Throughout the Poultry Production Chain in Greece.Foods (Basel, Switzerland) · 2025Article
- Urinary tract infections in older adults: associated factors for extended-spectrum beta-lactamase production.Frontiers in microbiology · 2024Article
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Authors and funding
10 authors at 7 institutions in 1 country.
Funding
Abstract
objectivesTreatment options for urinary tract infections (UTIs) caused by ESBL-producing Enterobacterales are limited. Moreover, evidence to support therapeutic decisions is lacking. This study assessed current treatment strategies and patient and pathogen characteristics in relation to clinical and microbiological outcomes.
methodsPatients with UTI caused by ESBL-producing Enterobacterales were prospectively recruited by investigators at 15 infectious disease hospital departments. Data were collected on patient characteristics, treatments, clinical and microbiological cure 10-14 days after the end of treatment, and relapse within 3 months. Bacterial isolates were subjected to MIC determination and WGS.
resultsIn total, 235 patients (107 febrile UTI, 128 lower UTI) caused by Escherichia coli (n = 223) and Klebsiella spp. (n = 12) were included. Clinical and microbiological cure rates were 83% and 64% in febrile UTI, and 79% and 65% in lower UTI. Great variability in treatments was observed, especially in oral therapy for febrile UTI. No difference was seen in clinical outcomes with piperacillin/tazobactam (n = 28) compared with carbapenems (n = 41). Pivmecillinam was frequently used in lower UTI (n = 62), and was also associated with high clinical cure rates when used as initial therapy (10/10) or follow-up (7/8) for febrile UTI. Recurrent infection, diabetes mellitus and urogenital disease were associated (P < 0.05) with clinical failure and relapse. In E. coli, ST131 was significantly associated with relapse, and haemolysin with microbiological failure or relapse.
conclusionsAntibiotic treatments were highly variable. Patient and pathogen factors were identified as potential determinants of disease presentation and outcomes and may prove useful to guide individualized treatment and follow-up.
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