Community-Associated Uropathogen Antimicrobial Resistance Among Emergency Department Patients With Acute Pyelonephritis
Community-Associated Uropathogen Antimicrobial Resistance Among Emergency Department Patients With Acute Pyelonephritis
Pyelonephritis is a serious infection that manifests with fever, back pain, nausea, and
 vomiting. In the U.S., it is estimated that there are 20 cases of pyelonephritis per 10,000
 annually, with the highest incidence in young women. Escherichia coli (E. coli) causes over
 80% of these infections. Over the last two decades, E. coli resistance has emerged to
 commonly prescribed antimicrobials, such as ampicillin and trimethoprim-sulfamethoxazole
 (TMP/SMX). Most recently, resistance to fluoroquinolones and strains producing
 extended-spectrum beta-lactamases (ESBL) have been observed. In order to better understand
 the evolution and current state of antibiotic resistance among E. coli urinary tract isolates
 so as to better inform treatment decisions, the investigators propose to conduct an
 investigation to: a) determine the prevalence of antimicrobial resistance among E. coli
 causing acute pyelonephritis in various patient groups, and specifically healthy
 community-dwellers with uncomplicated infections, b) determine the specific prevalence of
 fluoroquinolone-resistance and ESBL-producing E. coli, and c) determine potential risk
 factors for fluoroquinolone and ESBL-producing E. coli infections.
Inclusion Criteria:

 -  patients > 18 years of age with flank pain and/or costovertebral angle tenderness

 -  documented temperature in the emergency department of ≥38°C/100.4°F by any method of
 measurement,

 -  documented temperature in the emergency department of ≥38°C/100.4°F by any method of
 measurement,

 Exclusion Criteria:

 -  complicated pyelonephritis