• Lorenzo Onorato, Enrico Allegorico, Margherita Macera, Caterina Monari, Biagio Migliaccio, Carmine Nasta, Maria Teresa Florio, Roberta Sciorio, Fabio Giuliano Numis, Giovanna Guiotto, Mauro Giordano, Rosa Raucci, Ferdinando Dello Vicario, Rodolfo Nasti, Antonio Voza, Nicola Coppola, for UTILY study group, Federica Ciminelli, Ilaria De Luca, Annabella Salvati, Alessandro Cornelli, Piero Bianco, Stefano Aiello, Stefano Viola, Maria Rocco, Angela Di Sisto, Federico Schettini, Vincenzo Brunelli, Romeo Morelli, Francesca Palumbo, Alfredo Palumbo, Antonia Ida Facciuto, Valeria Palo, Martina Finelli, Antonio Allegretto, Mariachiara Giordano, Anna Amato, Anna Santagata, Adelaide Mariniello, Lucrezia Carozza, Nicola Quaranta, Vincenza Serrao, Augusto Delle Femine, Ilaria Guida, Annalisa Amelia, Federica Miglietta, Kim Russo, Federica Esposito, Filomena Fabozzi, Luca De Capua, and Evaluna Perez Guillen.
• Department of Mental Health and Public Medicine, Section of Infectious Diseases, University of Campania Luigi Vanvitelli, Naples, Italy.
• Eur. J. Intern. Med. 2024 Dec 30.

Background And AimThe aim of the present study was to evaluate the prevalence and to identify the independent predictors of multi-drug resistance among a cohort of patients admitted to emergency department for urinary tract infections (UTI), and to assess the impact of antimicrobial resistance on the clinical outcomes.MethodsWe conducted a prospective multicentre study enrolling all adult patients admitted to one of the eight emergency departments participating in the study with a microbiologically confirmed diagnosis of UTI from February 2023 to July 2024. The primary outcome evaluated was 30-day mortality; secondary outcomes included 7-day mortality and clinical response.ResultsDuring the study period, 681 patients were admitted to one of the 8 participating facilities with signs and symptoms consistent with UTI, 327 of which presented a positive urine culture and were included in the study. A total of 128 out of 327 patients (39.1 %) had an isolation of an MDR organism. At multivariate analysis, male gender (OR 1.79, 95 % CI 1.08-2.97, p = 0.024) and hospital admission during the previous 90 days (OR 4.28, 95 % CI 1.86-9.83, p = 0,001) resulted independently associated with the isolation of an MDR pathogen. Regarding clinical outcomes, the presence of sepsis or septic shock (OR 6.25, 95 % CI 1.36-28.73, p = 0.019), and being infected with an MDR pathogen (OR 2.65, 95 % CI 1.01-6.97, p = 0.048) resulted the only variables independently associated with 30-day mortality.ConclusionsOur study has reported a 39.1 % prevalence of MDR pathogens in patients admitted to emergency departments for UTI, with a 21 % prevalence among patients without any known risk factor.Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.

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