HOSPITALIZED CYSTITIS: PATIENT CHARACTERISTICS AND CHALLENGES IN THE MANAGEMENT OF MULTIDRUG-RESISTANT INFECTIONS
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Abstract
Objective: Cystitis is a common condition typically managed in an outpatient setting; however, some cases require hospitalization for intravenous antibiotic therapy. The rise of multidrug-resistant (MDR) bacteria, particularly MDR Enterobacteriaceae, complicates the selection of antibiotic regimens and extends length of stay. This study aimed to characterize clinical features, identify the bacterial spectrum and the degree of multidrug resistance, and evaluate the appropriateness of initial empirical antibiotic therapy.
Methods: A cross-sectional retrospective descriptive study was conducted among patients hospitalized for cystitis and receiving antibiotic treatment at the Department of Female Urology and Functional Urology, Binh Dan Hospital, from January 2025 to June 2025.
Results: Among 81 patients, 92.6% were female, with a median age of 64.0 (46.0–70.5) years. Escherichia coli accounted for 55.8% of positive cultures; among these isolates, 45.8% were extended-spectrum β-lactamase producing while 12.5% were carbapenemase producing. Carbapenems and amikacin maintained relatively effective activity, exhibiting susceptibility rates exceeding 50.0% and 66.7%, respectively. 70.4% of patients had received outpatient antibiotics within the preceding 90 days. Initial empirical antibiotic therapy adhered to the hospital guidelines in 23 out of 25 cases; however, only five out of sixteen cases indicated susceptibility based on antibiograms. Combination antibiotic therapy took up a tiny minority of patients at 19.8%. The median duration of treatment was 8 (7–10) days. No statistically significant differences in resistance enzyme production were observed across groups stratified by diabetes status or prior outpatient antibiotic usage.
Conclusion: Hospitalized cystitis is associated with a high rate of multidrug-resistant organisms, with Escherichia coli being the predominant pathogen. Prior outpatient antibiotic use and chronic conditions such as diabetes may influence the selection of initial antibiotic therapy.
Keywords
Cystitis, urinary tract infection, multidrug-resistant bacteria
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References
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