BACKGROUND Health care-associated urinary tract infection (HAUTI) consists of unique conditions (cystitis, pyelonephritis and urosepsis). These conditions could have different pathogen diversity and antibiotic resistance impacting on the empirical antibiotic choices. The aim of this study is to compare the estimated chances of coverage of empirical antibiotics between conditions (cystitis, pyelonephritis and urosepsis) in urology departments from Europe. METHODS A mathematical modelling based on antibiotic susceptibility data from a point prevalence study was carried. Data were obtained for HAUTI patients from multiple urology departments in Europe from 2006 to 2017. The primary outcome of the study is the Bayesian weighted incidence syndromic antibiogram (WISCA) and Bayesian factor. Bayesian WISCA is the estimated chance of an antibiotic to cover the causative pathogens when used for first-line empirical treatment. Bayesian factor is used to compare if HAUTI conditions did or did not impact on empirical antibiotic choices. RESULTS Bayesian WISCA of antibiotics in European urology departments from 2006 to 2017 ranged between 0.07 (cystitis, 2006, Amoxicillin) to 0.89 (pyelonephritis, 2009, Imipenem). Bayesian WISCA estimates were lowest in urosepsis. Clinical infective conditions had an impact on the Bayesian WISCA estimates (Bayesian factor > 3 in 81% of studied antibiotics). The main limitation of the study is the lack of local data. CONCLUSIONS Our estimates illustrate that antibiotic choices can be different between HAUTI conditions. Findings can improve empirical antibiotic selection towards a personalized approach but should be validated in local surveillance studies.

中文翻译：

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在与卫生保健相关的尿路感染中进行特定条件的监测，作为改善经验性抗生素治疗的策略：一项流行病学模型研究。

背景技术与保健相关的尿路感染（HAUTI）由独特的病症（膀胱炎，肾盂肾炎和尿道炎）组成。这些条件可能具有不同的病原体多样性和抗生素抗性，从而影响经验性抗生素的选择。这项研究的目的是比较欧洲泌尿科各病种（膀胱炎，肾盂肾炎和尿道炎）之间使用经验性抗生素的估计机会。方法进行了基于点流行性研究的抗生素敏感性数据的数学建模。从2006年至2017年从欧洲多个泌尿科获得了HAUTI患者的数据。该研究的主要结果是贝叶斯加权发病综合征抗生素谱（WISCA）和贝叶斯因子。当用于一线经验治疗时，贝叶斯WISCA是抗生素覆盖致病性病原体的估计机会。贝叶斯因子用于比较HAUTI条件是否影响经验性抗生素选择。结果2006年至2017年，欧洲泌尿科的贝叶斯WISCA抗生素介于0.07（膀胱炎，2006，阿莫西林）至0.89（肾盂肾炎，2009，亚胺培南）之间。贝叶斯WISCA估计值在尿糖中最低。临床感染状况对贝叶斯WISCA估计值有影响（81％的研究抗生素中贝叶斯因子> 3）。该研究的主要局限性是缺乏本地数据。结论我们的估计表明，HAUTI病情之间抗生素的选择可能有所不同。