İlknur KALELİ, Türkan TÜZÜN, Selda SAYIN KUTLU, Murat KUTLU

6781

Risk factors for community-onset urinary tract infections caused by extended-spectrum β-lactamase-producing Escherichia coli

Risk factors for community-onset urinary tract infections caused by extended-spectrum β-lactamase-producing Escherichia coli

Background/aim: Community-onset urinary tract infections (UTIs) caused by extended-spectrum β-lactamase (ESBL)-producingEscherichia coli have increased in many parts of the world. This study aimed to determine the prevalence and risk factors for communityonset UTI caused by ESBL-producing E. coli.Materials and methods: This prospective cohort study was conducted between January 2012 and March 2014 in cases of communityonset UTI caused by E. coli. Patients with UTI due to ESBL-producing E. coli and patients with UTI due to non-ESBL-producing E. coliwere compared to identify risk factors for ESBL-producing E. coli in the community.Results: A total of 305 patients (116 males [46.4%]; mean age: 57.76 ± 18.06 years) were included in the study. Among these patients, 154(50.5%) were infected with ESBL-producing E. coli. In multivariate analysis, the healthcare-associated UTI (odds ratio [OR]: 1.80; 95%confidence interval [CI]: 1.02–3.18; P = 0.041), upper urinary tract infection (OR: 3.05; 95% CI: 1.76–5.29; P < 0.0001), use of antibioticsin the preceding 6 months (OR: 2.28; 95% CI: 1.21–4.30; P = 0.011), and having two or more risk factors (OR: 4.03; 95% CI: 1.73–9.35;P = 0.001) were the significant factors associated with increased risk of community-onset UTIs due to ESBL-producing E. coli.Conclusion: The increasing prevalence of ESBL-producing E. coli makes it difficult to decide the empirical therapy in UTIs, especially inpatients with two or more of the risk factors. A better understanding of the epidemiology and risk factors associated with communityonset UTIs due to ESBL-producing E. coli may have significant implications in decision-making for empirical antimicrobial treatment.
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  • 1. Fan NC, Chen HH, Chen CL, Ou LS, Lin TY et al. Rise of community-onset urinary tract infection caused by extendedspectrum β-lactamase-producing Escherichia coli in children. Journal of Microbiology, Immunology and Infection 2014; 47 (5): 399-405. doi: 10.1016/j.jmii.2013.05.006
  • 2. Calbo E, Romaní V, Xercavins M, Gómez L, Vidal CG et al. Risk factors for community-onset urinary tract infections due to Escherichia coli harbouring extended-spectrum beta-lactamases. Journal of Antimicrobial Chemotherapy 2006; 57 (4): 780-783.
  • 3. Celik AD, Yulugkural Z, Kuloglu F, Eroglu C, Torol S et al. CTX-M type extended spectrum-lactamases in Escherichia coli isolates from community acquired upper urinary tract infections at a university in the European part of Turkey. Journal of Microbiology, Immunology and Infection 2010; 43 (2): 163-167. doi: 10.1016/S1684-1182(10)60026-6
  • 4. Martin D, Fougnot S, Grobost F, Thibaut-Jovelin S, Ballereau F et al. Prevalence of extended-spectrum beta-lactamase producing Escherichia coli in community-onset urinary tract infections in France in 2013. Journal of Infection 2016; 72 (2): 201-206. doi: 10.1016/j.jinf.2015.11.009
  • 5. Meier S, Weber R, Zbinden R, Ruef C, Hasse B. Extendedspectrum β-lactamase-producing Gram-negative pathogens in community-acquired urinary tract infections: an increasing challenge for antimicrobial therapy. Infection 2011; 39 (4): 333-340. doi: 10.1007/s15010-011-0132-6
  • 6. Lee SS, Kim Y, Chung DR. Impact of discordant empirical therapy on outcome of community-acquired bacteremic acute pyelonephritis. Journal of Infection 2011; 62 (2): 159-164. doi: 10.1016/j.jinf.2010.10.009
  • 7. Kung CH, Ku WW, Lee CH, Fung CP, Kuo SC et al. Epidemiology and risk factors of community-onset urinary tract infection caused by extended-spectrum β-lactamase-producing Enterobacteriaceae in a medical center in Taiwan: a prospective cohort study. Journal of Microbiology, Immunology and Infection 2015; 48 (2): 168-174. doi: 10.1016/j.jmii.2013.08.006
  • 8. Smithson A, Chico C, Ramos J, Netto C, Sanchez M et al. Prevalence and risk factors for quinolone resistance among Escherichia coli strains isolated from males with community febrile urinary tract infection. European Journal of Clinical Microbiology & Infectious Diseases 2012; 31 (4): 423-430. doi: 10.1007/s10096-011-1322-y
  • 9. Sobel JD, Kaye D. Urinary tract infections. In: Bennett JE, Dolin R, Blaser MJ (editors). Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases, 8th ed. Philadelphia, PA, USA: Elsevier; 2015. pp. 886-913.
  • 10. Clinical and Laboratory Standards Institute. Performance Standards for Antimicrobial Susceptibility Testing; Eighteenth Informational Supplement, M100-S18. Wayne, PA, USA: CLSI; 2009.
  • 11. Søraas A, Sundsfjord A, Sandven I, Brunborg C, Jenum PA. Risk factors for community-acquired urinary tract infections caused by ESBL-producing Enterobacteriaceae--a case-control study in a low prevalence country. PLoS One 2013; 8 (7): e69581. doi: 10.1371/journal.pone.0069581
  • 12. Al-Mayahie S, Al Kuriashy JJ. Distribution of ESBLs among Escherichia coli isolates from outpatients with recurrent UTIs and their antimicrobial resistance. Journal of Infection in Developing Countries 2016; 10 (6): 575-583. doi: 10.3855/ jidc.6661
  • 13. Den Heijer CD, Donker GA, Maes J, Stobberingh EE. Antibiotic susceptibility of unselected uropathogenic Escherichia coli from female Dutch general practice patients: a comparison of two surveys with a 5 year interval. Journal of Antimicrobial Chemotherapy 2010; 65 (10): 2128-2133. doi: 10.1093/jac/ dkq286
  • 14. Koksal I, Yilmaz G, Unal S, Zarakolu P, Korten V et al. Epidemiology and susceptibility of pathogens from SMART 2011-12 Turkey: evaluation of hospital-acquired versus communityacquired urinary tract infections and ICU- versus non-ICUassociated intra-abdominal infections. Journal of Antimicrobial Chemotherapy 2017; 72 (5): 1364-1372. doi: 10.1093/jac/ dkw574
  • 15. Rodríguez-Baño J, Alcalá JC, Cisneros JM, Grill F, Oliver A et al. Community infections caused by extended-spectrum beta-lactamase-producing Escherichia coli. Archives of Internal Medicine 2008; 168 (17): 1897-1902. doi: 10.1001/ archinte.168.17.1897
  • 16. Park YS, Bae IK, Kim J, Jeong SH, Hwang SS et al. Risk factors and molecular epidemiology of community-onset extendedspectrum β-lactamase-producing Escherichia coli bacteremia. Yonsei Medical Journal 2014; 55 (2): 467-475. doi: 10.3349/ ymj.2014.55.2.467
  • 17. Kang CI, Wi YM, Lee MY, Ko KS, Chung DR et al. Epidemiology and risk factors of community onset infections caused by extended-spectrum β-lactamase-producing Escherichia coli strains. Journal of Clinical Microbiology 2012; 50 (2): 312-317. doi: 10.1128/JCM.06002-11
  • 18. Rodríguez-Baño J, Picón E, Gijón P, Hernández JR, Ruíz M et al. Community-onset bacteremia due to extended-spectrum beta-lactamase-producing Escherichia coli: risk factors and prognosis. Clinical Infectious Diseases 2010; 50 (1): 40-48. doi: 10.1086/649537
  • 19. Chenoweth CE, Saint S. Urinary tract infections. Infectious Disease Clinics of North America 2011; 25 (1): 103-115. doi: 10.1016/j.idc.2010.11.005
  • 20. Parker V, Giles M, Graham L, Suthers B, Watts W et al. Avoiding inappropriate urinary catheter use and catheter-associated urinary tract infection (CAUTI): a pre-post control intervention study. BMC Health Services Research 2017; 17 (1): 314. doi: 10.1186/s12913-017-2268-2
  • 21. Yoshikawa TT, Norman DC. Geriatric infectious diseases: current concepts on diagnosis and management. Journal of the American Geriatrics Society 2017; 65 (3): 631-641. doi: 10.1111/jgs.14731
  • 22. Qiao LD, Chen S, Yang Y, Zhang K, Zheng B et al. Characteristics of urinary tract infection pathogens and their in vitro susceptibility to antimicrobial agents in China: data from a multicenter study. BMJ Open 2013; 3 (12): e004152. doi: 10.1136/ bmjopen-2013-004152
  • 23. Ben-Ami R, Rodríguez-Baño J, Arslan H, Pitout JD, Quentin C et al. A multinational survey of risk factors for infection with extended-spectrum beta-lactamase-producing Enterobacteriaceae in non-hospitalized patients. Clinical Infectious Diseases 2009; 49 (5): 682-690. doi: 10.1086/604713
  • 24. Rodríguez-Baño J, Navarro MD, Romero L, Martínez-Martínez L, Muniain MA et al. Epidemiology and clinical features of infections caused by extended-spectrum beta-lactamaseproducing Escherichia coli in nonhospitalized patients. Journal of Clinical Microbiology 2004; 42 (3): 1089-1094.
  • 25. Azap OK, Arslan H, Serefhanoğlu K, Colakoğlu S, Erdoğan H et al. Risk factors for extended-spectrum beta-lactamase positivity in uropathogenic Escherichia coli isolated from community-acquired urinary tract infections. Clinical Microbiology and Infection 2010; 16 (2): 147-151. doi: 10.1111/j.1469- 0691.2009.02941.x
  • 26. Yilmaz E, Akalin H, Ozbey S, Kordan Y, Sinirtaş M et al. Risk factors in community-acquired/onset urinary tract infections due to extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae. Journal of Chemotherapy 2008; 20 (5): 581-585.
  • 27. Colodner R, Rock W, Chazan B, Keller N, Guy N et al. Risk factors for the development of extended-spectrum beta-lactamase producing bacteria in nonhospitalized patients. European Journal of Clinical Microbiology & Infectious Diseases 2004; 23 (3): 163-167.
  • 28. Chervet D, Lortholary O, Zahar JR, Dufougeray A, Pilmis B et al. Antimicrobial resistance in community-acquired urinary tract infections in Paris in 2015. Médecine et Maladies Infectieuses 2018; 48 (3): 188-192. doi: 10.1016/j.medmal.2017.09.013
  • 29. Can F, Azap OK, Seref C, Ispir P, Arslan H et al. Emerging Escherichia coli O25b/ST131 clone predicts treatment failure in urinary tract infections. Clinical Infectious Diseases 2015; 60 (4): 523-527. doi: 10.1093/cid/ciu864
Turkish Journal of Medical Sciences-Cover
  • ISSN: 1300-0144
  • Yayın Aralığı: 6
  • Yayıncı: TÜBİTAK
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