You have accessJournal of UrologyInfections/Inflammation/Cystic Disease of the Genitourinary Tract: Kidney & Bladder II (MP77)1 Apr 2020MP77-17 RESISTANCE PATTERNS AS DETECTED BY UROBIOME ANTIBIOTIC SUSCEPTIBILITY TESTING (U-AST) IN POLYMICROBIAL URINARY TRACT INFECTIONS Annah Vollstedt*, Natalie Luke, Kirk Wonjo, Colleen Kelly, David Smith, David Banouch, Michael Opel, Howard Korman, Patrick Keating, Frank Burks, Mohammad Jafri, Kevin Cline, Laurence LaBelkoff, Aaron Milbank, Neil Sherman, Rashel Haverkorn, Laurence Yore, Neil Shore, Andrea Cronican, Jason Atler, Rajesh Patel, and Larry Sirls Annah Vollstedt*Annah Vollstedt* More articles by this author , Natalie LukeNatalie Luke More articles by this author , Kirk WonjoKirk Wonjo More articles by this author , Colleen KellyColleen Kelly More articles by this author , David SmithDavid Smith More articles by this author , David BanouchDavid Banouch More articles by this author , Michael OpelMichael Opel More articles by this author , Howard KormanHoward Korman More articles by this author , Patrick KeatingPatrick Keating More articles by this author , Frank BurksFrank Burks More articles by this author , Mohammad JafriMohammad Jafri More articles by this author , Kevin ClineKevin Cline More articles by this author , Laurence LaBelkoffLaurence LaBelkoff More articles by this author , Aaron MilbankAaron Milbank More articles by this author , Neil ShermanNeil Sherman More articles by this author , Rashel HaverkornRashel Haverkorn More articles by this author , Laurence YoreLaurence Yore More articles by this author , Neil ShoreNeil Shore More articles by this author , Andrea CronicanAndrea Cronican More articles by this author , Jason AtlerJason Atler More articles by this author , Rajesh PatelRajesh Patel More articles by this author , and Larry SirlsLarry Sirls More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000963.017AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Previous studies have shown that as many as 39% of urine cultures from elderly patients are polymicrobial. The interaction between bacterial species can alter response to antibiotic therapy. We describe the resistance patterns seen within polymicrobial infections using U-AST in patients presenting to a large urologic practice with UTI symptoms. METHODS: Urine samples were collected from patients with symptoms of UTI. PCR was performed to identify and quantitate the presence of organisms. Resistance was detected using a U-AST method, Figure 1. Logistic regression analysis was used to account for the effects of all bacteria present and detect significant interactions between bacteria. RESULTS: Urine samples were collected from 3,124 patients, median age 74, 51% female. PCR reported a polymicrobial infections in 32% (1002/3124) of samples. An example of clinically relevant mutualism in polymicrobial infections is presented. There were 27 samples with both E. coli and K. pneumoniae, 558 with E. coli without K. pneumonia and 118 with K. pneumonia without E. coli. Polymicrobial infections with E. coli and K. pneumoniae showed increased resistance to cefaclor (p<0.0001), cefazolin (p=0.005), cefepime (p=0.008), cefoxitin (p=0.003), ceftazidime (p=0.0001), ceftriaxone (p=0.0005), ciprofloxacin (p=0.004), levofloxacin (p=0.008) and meropenem (p=0.007) than monomicrobial E. coli and K. pneumoniae infections, Figure 2. CONCLUSIONS: Organism interactions in polymicrobial infections affect resistance patterns compared to monomicrobial infections. U-AST may help better understand these interactions and guide antibiotic choice. More research is needed to evaluate the potential advantage of U-AST in clinical practice. Source of Funding: Pathnostics © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e1170-e1170 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Annah Vollstedt* More articles by this author Natalie Luke More articles by this author Kirk Wonjo More articles by this author Colleen Kelly More articles by this author David Smith More articles by this author David Banouch More articles by this author Michael Opel More articles by this author Howard Korman More articles by this author Patrick Keating More articles by this author Frank Burks More articles by this author Mohammad Jafri More articles by this author Kevin Cline More articles by this author Laurence LaBelkoff More articles by this author Aaron Milbank More articles by this author Neil Sherman More articles by this author Rashel Haverkorn More articles by this author Laurence Yore More articles by this author Neil Shore More articles by this author Andrea Cronican More articles by this author Jason Atler More articles by this author Rajesh Patel More articles by this author Larry Sirls More articles by this author Expand All Advertisement PDF downloadLoading ...