EDs may struggle to identify patients at risk for antibiotic-resistant infections, study finds

Drug-resistant bacteria caused almost 6 percent of urinary tract infections at a California emergency department analyzed during a one-year study, and many patients had no identifiable risk for this type of infection, a study published in Annals of Emergency Medicine found.

The study involved retrospective analysis of 1,745 urinary cultures from patients with urinary tract infections at a California ED between August 2016 and July 2017.

The authors say antibiotic-resistant Escherichia coli (most of the bacteria analyzed in the study) have been infecting more people outside the hospital, especially patients with UTIs. The study found 44 percent of the infections analyzed were contracted outside the hospital, the highest proportion reported in the U.S. to date.

Changes to clinical practice can include broader use of urine culture tests; improving emergency physician awareness of their hospital's chart showing whether certain antibiotics work against certain bacteria; and knowing which antibiotics to avoid, the authors said.

"What's new is that in many of these resistant urinary tract infections, it may simply be impossible to identify which patients are at risk," said lead study author Bradley Frazee, MD. "Addressing the causes of antibiotic resistance, and developing novel drugs, is imperative."

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