{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T07:52:41Z","timestamp":1753861961782,"version":"3.41.2"},"reference-count":21,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2019,12,5]],"date-time":"2019-12-05T00:00:00Z","timestamp":1575504000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acute Medicine &amp; Surgery"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:sec><jats:title>Aim<\/jats:title><jats:p>In severe urinary tract infection (UTI), susceptible antibiotics should be given. With the recent increase of multidrug\u2010resistant bacteria, especially extended spectrum beta\u2010lactamase producing Enterobacteriaceae (ESBL\u2010E), broad\u2010spectrum antibiotics, such as carbapenems, are used more frequently, which could lead to a further increase of multidrug\u2010resistant bacteria. We aimed to analyze the relationship between initial empirical antibiotic appropriateness and clinical outcomes in UTI, especially in patients with systemic inflammatory response syndrome (SIRS) and ESBL\u2010E.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective observational study from 2012 to 2017.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among urine culture\u2010positive cases with \u226510<jats:sup>5<\/jats:sup>\u00a0colony\u2010forming units\/mL (<jats:italic>n<\/jats:italic>\u00a0=\u00a01,880), true UTI cases were extracted (<jats:italic>n<\/jats:italic>\u00a0=\u00a0844) and divided into the SIRS group (<jats:italic>n<\/jats:italic>\u00a0=\u00a0336 [ESBL\u2010E12.8% (43\/336)]) and non\u2010SIRS group (<jats:italic>n<\/jats:italic>\u00a0=\u00a0508 [ESBL\u2010E12.6% (64\/508)]). In the SIRS ESBL\u2010E group, the initial antibiotics were susceptible in 55.8% (24\/43), among which 91.7% (22\/24) improved and 8.3% (2\/24) deteriorated or died. The initial antibiotics were resistant in 44.2% (19\/43), among which 47.4% (9\/19) improved with the initial antibiotics, 47.4% (9\/19) improved after escalating antibiotics, and 5.3% (1\/19) deteriorated or died. In the SIRS group, 14 cases had true bacteremia with ESBL\u2010E. Seven cases were initiated with inappropriate antibiotics; four cases showed improvement before or without antibiotic change and three cases improved after antibiotic escalation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Initiation of narrow\u2010spectrum antibiotics in septic UTI with ESBL\u2010E might not deteriorate the clinical outcome if promptly escalated on clinical deterioration or with ESBL\u2010E culture results. Further investigation is warranted to guide judicious use of initial antibiotics.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ams2.472","type":"journal-article","created":{"date-parts":[[2019,12,6]],"date-time":"2019-12-06T07:58:37Z","timestamp":1575619117000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Clinical outcomes of urinary tract infection caused by extended spectrum beta\u2010lactamase producing Enterobacteriaceae: a retrospective observational study comparing patients with and without systemic inflammatory response syndrome"],"prefix":"10.1002","volume":"7","author":[{"given":"Yuka","family":"Kitano","sequence":"first","affiliation":[{"name":"Department of Emergency and Critical Care Medicine Yokohama City Seibu Hospital St. Marianna University School of Medicine Yokohama Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haruaki","family":"Wakatake","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine Yokohama City Seibu Hospital St. Marianna University School of Medicine Yokohama Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroki","family":"Saito","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine Yokohama City Seibu Hospital St. Marianna University School of Medicine Yokohama Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ken","family":"Tsutsumi","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine Yokohama City Seibu Hospital St. Marianna University School of Medicine Yokohama Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hideki","family":"Yoshida","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine St. Marianna University School of Medicine Kawasaki Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Minoru","family":"Yoshida","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine Yokohama City Seibu Hospital St. Marianna University School of Medicine Yokohama Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mumon","family":"Takita","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine St. Marianna University School of Medicine Kawasaki Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toru","family":"Yoshida","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine Yokohama City Seibu Hospital St. Marianna University School of Medicine Yokohama Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshihiro","family":"Masui","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine Yokohama City Seibu Hospital St. Marianna University School of Medicine Yokohama Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasuhiko","family":"Taira","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine St. Marianna University School of Medicine Kawasaki Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6327-682X","authenticated-orcid":false,"given":"Shigeki","family":"Fujitani","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine St. Marianna University School of Medicine Kawasaki Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,12,5]]},"reference":[{"volume-title":"StatPearls","year":"2019","author":"Belyayeva M","key":"e_1_2_8_2_1"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cis942"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.18.4.657-686.2005"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra0904124"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1086\/420816"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00607-13"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmii.2010.06.001"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10156-010-0174-1"},{"key":"e_1_2_8_10_1","first-page":"181","article-title":"[In vitro susceptibilities to levofloxacin and various antibacterial agents of 12,866 clinical isolates obtained from 72 centers in 2010]","volume":"65","author":"Yamaguchi K","year":"2012","journal-title":"Jpn. J. Antibiot."},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.12163"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciw741"},{"key":"e_1_2_8_13_1","unstructured":"WHO|Global action plan on AMR. WHO. [cited 2019 Jul 12]. Available from:http:\/\/www.who.int\/antimicrobial-resistance\/global-action-plan\/en\/."},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-015-1054-1"},{"key":"e_1_2_8_15_1","first-page":"A\u20101","volume-title":"APIC Infection Control and Applied Epidemiology: Principles and Practice","author":"Garner JS","year":"1996"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-199206000-00025"},{"volume-title":"Performance Standards for Antimicrobial Susceptibility Testing","year":"2017","author":"Clinical and Laboratory Standards Institute (CLSI)","key":"e_1_2_8_17_1"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-017-4683-6"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12941-017-0191-3"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0160203"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13104-017-2680-z"},{"key":"e_1_2_8_22_1","doi-asserted-by":"crossref","first-page":"303","DOI":"10.7883\/yoken.JJID.2005.303","article-title":"Pathogen occurrence and antimicrobial susceptibility of urinary tract infection cases during a 20\u2010year period (1983\u20132002) at a single institution in Japan","volume":"58","author":"Shigemura K","year":"2005","journal-title":"Jpn. J. Infect. Dis."}],"container-title":["Acute Medicine &amp; Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fams2.472","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ams2.472","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ams2.472","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ams2.472","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,28]],"date-time":"2024-07-28T06:32:48Z","timestamp":1722148368000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ams2.472"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,12,5]]},"references-count":21,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,1]]}},"alternative-id":["10.1002\/ams2.472"],"URL":"https:\/\/doi.org\/10.1002\/ams2.472","archive":["Portico"],"relation":{},"ISSN":["2052-8817","2052-8817"],"issn-type":[{"type":"print","value":"2052-8817"},{"type":"electronic","value":"2052-8817"}],"subject":[],"published":{"date-parts":[[2019,12,5]]},"assertion":[{"value":"2019-08-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-11-04","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-12-05","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e472"}}