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■ Urinary tract infections (UTIs) are among the most frequent healthcare-associated (HCA) infections. Escherichia coli is the most common UTI pathogen observed in both the community and healthcare settings. In recurrent UTI, and especially when structural abnormalities of the urinary tract are present, the relative frequency of Klebsiella spp., Proteus spp., Pseudomonas spp., and Enterobacter spp. increases. Antimicrobial-resistant isolates are common in these complicated UTIs (cUTIs) in which instrumentation and repeat courses of antimicrobial therapy are frequently used. ■ Antimicrobial-resistant strains that produce extended-spectrum β-lactamases (ESBLs) are prevalent among Enterobacteriaceae, predominantly E. coli and Klebsiella spp., and have become endemic in many hospitals. Pseudomonas aeruginosa also represents a major cause of UTI, and often demonstrates decreased susceptibility to various antimicrobial agents. INTRODUCTION RESULTS (cont’d)

open forum infectious diseases

246Frequency of Occurrence and Antimicrobial Susceptibility of Gram-negative Organisms Isolated from Health Care–Associated (HCA) Urinary Tract Infections (UTI) in the United States: Results from the Program to Assess Ceftolozane/Tazobactam Susceptibility (PACTS)