The information collected will optimize the management of patients with urinary tract infections with secondary bacteremia, primarily with gram negative bacteria especially Escherichia coli. The current IDSA guideline endorses the use of fluoroquinolones and trimethoprim-sulfamethoxazole as the first line agents. However, over use of this empiric regimen could result in in appropriate treatment of bacteremia.

The following information will be collected: age, sex, occupation, hospital location at the time of positive culture (ER, medical ward, ICU etc), prior hospitalization, receipt of outpatient dialysis, home care or other regular medical care (eg, outpatient chemotherapy), presence of invasive devices, receipt of antibiotics, including their type and whether they were adequate for the resistance profile of the organism, prior positive microbiologic cultures, time and location of positive cultures, underlying diseases and severity of illness, presence of urinary or intravascular devices, recent immunomodulative therapies or radiation therapy, physical exam findings, laboratory and radiographical data, antimicrobial usage within 30 days of onset of the infection, microbiological data and resistance patterns, choice of antibiotics once organism identified, bacteriological outcomes, laboratory results, demographic information, medications, clinical outcome,gender, height, weight, ethnicity, and past medical history. We will collect information retrospectively.

Inclusion Criteria:

• Clinical information is collected by chart review of "case" and "control" patients. A "case" patient is defined as follows:

  • One or more blood cultures are positive for Gram-negative bacteria.
  • The same organism is recovered in urine culture within a 48-hour period.
  • The organism is ciprofloxacin resistant.

• A "control" patient is defined as follows:

  • One or more blood cultures are positive for Gram-negative bacteria.
  • The same organism is recovered in urine culture within a 48-hour period.
  • The organism is ciprofloxacin susceptible.

Exclusion Criteria:

• negative culture

postive gram negative culture