Impact of the beta-lacta test on the management of urinary tract infections at the emergency department

Infect Dis (Lond). 2021 Jan;53(1):52-60. doi: 10.1080/23744235.2020.1822543. Epub 2020 Sep 22.

Abstract

Introduction: Rapid detection of extended-spectrum β-lactamases is essential. In this study, we evaluated the potential impact of β-lacta test on both the times to appropriate antibiotic therapy and to the implementation of patient isolation measures.

Patients and methods: We included prospectively all the patients admitted to the emergency department for clinical suspicion of urinary tract infection. Compared with physician's decision, we analysed the potential impact of β-lacta test on the initial antibiotic therapy and on the implementation of hygiene measures. This study has been registered under number NCT02897609.

Results: We included 203 patients, 43% with acute pyelonephritis and 21% with acute prostatitis. The β-lacta test had a 95.2% sensitivity and a 99.5% specificity to detect extended-spectrum β-lactamases. Taking the β-lacta test results into account would have decreased significantly both the times to appropriate therapy and to isolation measures from 54 to 2.7 h and from 55.2 to 2.6 h, respectively.

Conclusion: The β-lacta test could reduce significantly the times to appropriate therapy and implementation of isolations measures.

Keywords: Beta-lacta test; emergency department; urinary tract infections.

Publication types

  • Clinical Trial

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Emergency Service, Hospital
  • Humans
  • Male
  • Urinary Tract Infections* / diagnosis
  • Urinary Tract Infections* / drug therapy
  • beta-Lactamases*

Substances

  • Anti-Bacterial Agents
  • beta-Lactamases

Associated data

  • ClinicalTrials.gov/NCT02897609