Data for hospital antibiograms are typically compiled from all patients, regardless of disposition, demographics and other comorbidities. We hypothesized that the sensitivity patterns for urinary pathogens would differ significantly from the hospital antibiogram in patients that were discharged from the emergency department (ED). We evaluated a retrospective cohort of all adult patients with positive urine cultures treated in the 2016 calendar year at an inner-city academic ED. Positive urine cultures defined by our institution’s microbiology department. Investigators conducted a structured review of an electronic medical record (EMR) to collect demographic, historical and microbiology records. We utilized a one-sample test of proportion to compare the sensitivity of each organism for discharged patients to the hospital published antibiogram. Alpha set at 0.05. During the study period, 414 patients were discharged from the ED and found to have positive urine cultures; 20% age > 60 years old, 85% female, 79% Hispanic, 33% diabetic. The most common organisms was E. coli (78%). E. coli was sensitive to Trimethoprim-Sulfamethoxazole for 59% vs. 58% in our antibiogram (p = 0.77), Ciprofloxacin 81% vs. 69% (p < 0. 001), Nitrofurantoin 96% vs 95%; (p = 0.25). K. pneumoniae was sensitive to Trimethoprim-Sulfamethoxazole 87% vs. 80% in our antibiogram (p = 0.26), Ciprofloxacin 100% vs. 92% (p = 0.077), Nitrofurantoin 86% vs 41% (p < 0.001). For our predominantly Hispanic study group with a high prevalence of diabetes, we found that our hospital antibiogram had relatively good value in guiding antibiotic therapy though for some organism/antibiotic combinations sensitivities were higher than expected.

中文翻译：

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急诊科出院患者尿液病原体敏感性与医院抗菌谱比较

通常会从所有患者收集医院抗菌素数据，而不考虑其处境，人口统计学和其他合并症。我们假设，从急诊科（ED）出院的患者中，尿中病原体的敏感性模式与医院的抗菌素显着不同。我们评估了2016日历年在市中心学术ED中接受尿液培养阳性的所有成年患者的回顾性队列研究。阳性尿培养由我们机构的微生物学部门定义。研究人员对电子病历（EMR）进行了结构化审查，以收集人口统计，历史和微生物学记录。我们使用了一个样本的比例测试，以比较每种生物对出院患者的敏感性与医院公布的抗菌素谱。Alpha设置为0.05。在研究期间，有414名患者从急诊室出院，发现尿培养阳性。20％年龄> 60岁，女性85％，西班牙裔79％，糖尿病33％。最常见的生物是大肠杆菌（78％）。大肠杆菌对甲氧苄氨嘧啶-磺胺甲基异恶唑的敏感度分别为59％和58％（p = 0.77），环丙沙星81％和69％（p <0. 001），呋喃妥因96％和95％。（p ＝ 0.25）。肺炎克雷伯菌对抗菌素甲氧苄氨嘧啶-磺胺甲基异恶唑的敏感度分别为87％和80％（p = 0.26），环丙沙星100％和92％（p = 0.077），呋喃妥因86％和41％（p <0.001）。对于我们以糖尿病为高患的以西班牙裔为主的研究小组，