Prevalence and risk factors for multidrug resistant uropathogens in ED patients

The purpose of this study was to describe resistance patterns of infecting organisms and determine risk factors for multidrug resistance in patients w ith urinary tract infections. Retrospective case series of 435 patients age greater than or equal to 16 with urinary tract infection. Multidrug resist ance was defined as resistance to greater than or equal to two classes of a ntibiotics, Demographic, historical, and microbiological data were collecte d. Univariate analysis and multivariate logistic regression were used to de termine risk factors for multidrug resistance, Multidrug resistance was see n in 37% of isolates. Univariate analysis revealed numerous associations wi th resistance. Multivariate analysis found three independent factors associ ated with multidrug resistance: urinary catheter use (odds ratio [OR] 2.6, 95% confidence interval [CI] 1.4 to 4.8), age greater than or equal to 65 y ears (OR 3.0, 95% CI 1.7 to 5.4) and antibiotic use (OR 4.6, 95% CI 2.8 to 7.5). Diabetes was also a risk factor when patients with urinary catheters were excluded (OR 2.4, 95% CI 1.1 to 5.3), Resistance was seen in all group s of patients, but was particularly common in older patients and those who used a urinary catheter. Antibiotic use was highly associated with multidru g resistance. (Am J Emerg Med 2000;18:143-146. Copyright (C) 2000 by W.B. S aunders Company).