Bacteriuria resistance patterns and the suitability of urinalysis as an initial diagnostic tool in a post-antibiotic era
| Autor: | James Edward Dyer, Zara Gall, Samih Taktak |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty Urinalysis medicine.drug_class Urology Urinary system urinalysis 030106 microbiology Antibiotics Population Bacteriuria Urine bacteriuria resistance 03 medical and health sciences 0302 clinical medicine Antibiotic resistance Internal medicine medicine 030212 general & internal medicine education bacteria education.field_of_study medicine.diagnostic_test business.industry Antibiotic medicine.disease Trimethoprim Diseases of the genitourinary system. Urology infection Original Article RC870-923 business medicine.drug |
| Zdroj: | Therapeutic Advances in Urology Therapeutic Advances in Urology, Vol 13 (2021) |
| ISSN: | 1756-2880 1756-2872 |
| Popis: | Aims: Urinalysis is used as a first-line investigation throughout healthcare to indicate bacteriuria and guide treatment of potential urinary tract infections. In light of rising bacterial multi-resistance, we aim to analyse its diagnostic accuracy, determine its usefulness in a present-day setting and evaluate current antibiotic resistance patterns across a Trust population. Methods: A retrospective case series of 712 paired urinalysis and urine culture results was obtained over a 1-month period. Sensitivity, specificity and diagnostic accuracy were calculated, and resistance profiles of commonly used Trust antibiotics assessed using statistical analysis. Results: A high false negative rate of nitrites on urinalysis, with sensitivity of 38.4%, was found. Leucocyte sensitivity was 87.6% and specificity 39.7%, with no improvement in diagnostic accuracy seen when combining both. Positive urine culture growth demonstrated a substantial resistance pattern to trimethoprim of 48%, compounded by a statistically significant correlation with gentamicin resistance ( p Conclusion: Our study has highlighted a reduced accuracy of urinalysis compared with previous literature, questioning its usefulness in the real world. We have consolidated growing published trends doubting the efficacy of trimethoprim, revealing co-existing resistance patterns between commonly used antibiotics. This will have implications for future antibiotic-prescribing protocols and requires further research to ensure guidelines are progressive in consciously managing this growing concern in modern-day healthcare. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|