Outcomes of urinary tract infections caused by resistant strains of E. coli on an outpatient basis
The growth of antibiotic resistance is one of the most important problems of modern medicine, threatening public health. However, the practical consequences of infections caused by resistant strains of pathogens for patients, as well as for the medical facilities of the outpatient department, are not well understood.
The purpose of the case-control study of C.C. Butler et al. (United Kingdom), was a comparative evaluation of the clinical results of outpatient treatment of urinary tract infections (UTIs) caused by susceptible and resistant strains of Escherichia coli. The work included data obtained from the ambulatory documentation of 932 patients with UTI, the etiological role of E.coli in which was confirmed microbiologically, as well as the results of their investigation after 1 month.
Survey results suggest that the probability of a patient reporting "feeling bad", "increasing the frequency of urination or pain during urination" and "being unable to work" 5 days or more after consulting a doctor was significantly higher in patients with UTI. resistant strains of E. coli. The likelihood of complaining of "increased urination or pain during urination", as well as "disability" remained higher in this group of patients and in the analysis taking into account risk factors. The maximum duration of the presence of at least one of the above symptoms was on average 12 days with the resistance of the strain E. coli which caused the infection with trimethoprim, 7 days to any other antibiotic, including ampicillin, and 5 days - with the sensitivity of an etiologically significant pathogen to all of the drugs tested.
Slower resolution of symptoms of urinary tract infection caused by resistant strains of E. coli has been noted, even with adequate antibiotic therapy. When the pathogen was resistant to at least one antibacterial drug, the odds ratio for a patient to see a doctor again for a UTI in the next 30 days was 1.47 (confidence interval (CI) 95% 1.10-1.95). With resistance to ampicillin, this indicator reached 1.49 (95% CI 1.11-2), trimethoprim - 2.48 (95% CI 1.70-3.59).
Thus, urinary tract infections caused by resistant strains of E. coli are subject to slow resolution, which increases the load on the ambulatory care unit.