Travel to Mexico and uropathogen-antibiotic susceptibility mismatch in the emergency department

Erica L. Torres, Jonathon R. Cantu, Daniela Z. Bazan, Rene A. Verduzco, José J. Hernández-Muñoz

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Introduction: International travel results in an increased risk of colonization and infection with multidrug-resistant organisms. This study aimed to determine if recent travel to Mexico affects the rate of uropathogen-antibiotic susceptibility mismatch (UASM) in outpatients treated for urinary tract infection (UTI) in a South Texas emergency department (ED). Methods: A retrospective cohort of adult patients presenting to the ED and treated outpatient for UTI from October 1, 2014, to February 25, 2020, was conducted at a community hospital located within approximately 15 miles of the United States-Mexico border. Rates of UASM were compared between patients with a history of recent travel to Mexico and those who have not recently traveled. Results: A total of 192 patients were included, with 64 in the travel to Mexico group and 128 in the no travel group. UASM was significantly higher in the recent travel to Mexico group when compared to the no travel group (RR 1.49, 95% CI 1.03–2.13). Antibiotics most commonly associated with UASM included fluoroquinolones, cephalexin, and sulfamethoxazole-trimethoprim. There was no significant difference between the rates of resistance to first-line agents for the treatment of UTI among the two groups. Conclusion: In addition to known antibiotic resistance risk factors, recent travel to Mexico may increase the risk of UASM for ED patients with UTI. Considering the potential consequences of UTI treatment failure, antimicrobial stewardship services in the ED should include screening for antibiotic resistance risk factors and urine culture follow-up to ensure appropriate outpatient antibiotic therapy, especially among patients with recent international travel.

Original languageEnglish (US)
Pages (from-to)619-624
Number of pages6
JournalAmerican Journal of Emergency Medicine
Volume46
DOIs
StatePublished - Aug 2021

Keywords

  • Antibiotic resistance
  • Bacterial
  • Emergency service
  • Hospital
  • Mexico
  • Travel
  • Treatment failure
  • Urinary tract infection

ASJC Scopus subject areas

  • Emergency Medicine

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