{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T02:46:16Z","timestamp":1773024376658,"version":"3.50.1"},"reference-count":30,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2020,7,23]],"date-time":"2020-07-23T00:00:00Z","timestamp":1595462400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Foundation for Development of the Community","award":["Research grant"],"award-info":[{"award-number":["Research grant"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>A specific antibiogram is necessary for the empiric antibiotic treatment of community-acquired urinary tract infections (UTI) because of the global spread of antimicrobial resistance. This study aimed to develop an antibiogram specific for community-acquired UTI and assess the risk factors associated with community-acquired UTI caused by antimicrobial-resistant organisms. This cross-sectional observational retrospective study included patients with community-acquired UTI caused by Gram-negative rods (GNR) who were admitted to the emergency department at a tertiary care hospital in Ibaraki, Japan, in 2017\u20132018. A total of 172 patients were enrolled (including 38 nursing home residents). Of the 181 GNR strains considered as causative agents, 135 (75%) were Escherichia coli, and 40 (22%) exhibited third-generation cephalosporin resistance. Extended-spectrum \u03b2-lactamase (ESBL)-producing E. coli accounted for 25\/40 (63%) of resistant GNR. Overall susceptibility rate of Enterobacterales was 92%, 81%, 100%, 75%, and 89% for cefmetazole, ceftriaxone, meropenem, levofloxacin, and trimethoprim\u2013sulfamethoxazole, respectively. Residence in a nursing home (odds ratio (OR), 2.83; 95% confidence interval (CI), 1.18\u20136.79) and recent antibiotic use (OR, 4.52; 95% CI, 1.02\u201319.97) were independent risk factors for UTI with resistant GNR. ESBL-producing E. coli was revealed to have a strong impact on antimicrobial resistance pattern. Therefore, an antibiotic strategy based on a disease-specific antibiogram is required.<\/jats:p>","DOI":"10.3390\/antibiotics9080438","type":"journal-article","created":{"date-parts":[[2020,7,23]],"date-time":"2020-07-23T10:14:06Z","timestamp":1595499246000},"page":"438","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Gram-negative Organisms from Patients with Community-Acquired Urinary Tract Infections and Associated Risk Factors for Antimicrobial Resistance: A Single-Center Retrospective Observational Study in Japan"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8003-534X","authenticated-orcid":false,"given":"Naoki","family":"Kanda","sequence":"first","affiliation":[{"name":"Division of General Internal Medicine, Jichi Medical University Hospital, Tochigi 329-0498, Japan"},{"name":"Department of Emergency and Critical Care Medicine, Hitachi General Hospital, Ibaraki 317-0077, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hideki","family":"Hashimoto","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine, Hitachi General Hospital, Ibaraki 317-0077, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomohiro","family":"Sonoo","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine, Hitachi General Hospital, Ibaraki 317-0077, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiromu","family":"Naraba","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine, Hitachi General Hospital, Ibaraki 317-0077, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9776-2647","authenticated-orcid":false,"given":"Yuji","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine, Hitachi General Hospital, Ibaraki 317-0077, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8481-0294","authenticated-orcid":false,"given":"Kensuke","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine, Hitachi General Hospital, Ibaraki 317-0077, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2684-1695","authenticated-orcid":false,"given":"Shuji","family":"Hatakeyama","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine, Jichi Medical University Hospital, Tochigi 329-0498, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2020,7,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1086\/519268","article-title":"Population-based epidemiologic analysis of acute pyelonephritis","volume":"45","author":"Czaja","year":"2007","journal-title":"Clin. 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