scholarly journals Risk Factors for Community-Acquired Extended-Spectrum Beta-Lactamase–Producing Enterobacteriaceae Infections—A Retrospective Study of Symptomatic Urinary Tract Infections

2019 ◽  
Vol 6 (2) ◽  
Author(s):  
Dheeraj Goyal ◽  
Nathan Dean ◽  
Sarah Neill ◽  
Peter Jones ◽  
Kristin Dascomb
Keyword(s):  
Risk Factors ◽  
Urinary Tract ◽  
Urinary Catheter ◽  
Univariate Analysis ◽  
Public Health Problem ◽  
Beta Lactamase ◽  
Extended Spectrum Beta Lactamase ◽  
Extended Spectrum ◽  
History Of ◽  
Tract Infections

Abstract Background Community-acquired extended-spectrum beta-lactamase–producing Enterobacteriaceae (ESBL) infections are an evolving public health problem. Identifying predictive risk factors may improve patient management. Methods We identified 251 adult inpatients admitted to a 22-hospital system with an ESBL urinary tract infection (UTI) between 2001 and 2016. Cases were matched 1:1 with controls who had a UTI at admission with non-ESBL Enterobacteriaceae. Cases with a history of ESBL infections or hospitalization within 3 months of index admission were excluded. Univariate and multiple logistic regression were used to identify risk factors associated with ESBL UTIs. Results In univariate analysis, history of repeated UTIs, neurogenic bladder, urinary catheter presence at admission, and exposure to outpatient third-generation cephalosporins or fluoroquinolones within 3 months were associated with higher risk of ESBL UTIs. When controlling for severity of illness and comorbid conditions, history of repeated UTIs (adjusted odds ratio [aOR], 6.40; 95% confidence interval [CI], 3.42–12.66; P < .001), presence of urinary catheter at admission (aOR, 2.36; 95% CI, 1.15–4.98; P < .05), and prior antibiotic exposure (aOR, 7.98; 95% CI, 2.92–28.19; P < .001) remained associated with risk of ESBL infection. Conclusions Patients in the community with indwelling urinary catheters, history of recurrent UTIs, or recent antimicrobial use are at higher risk for de novo ESBL Enterobacteriaceae UTIs.

scholarly journals Risk Factors for Community Acquired Extended-Spectrum Β-lactamase (ESBL) Producing Enterobacteriaceae Urinary Tract Infections (UTIs)

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S345-S345
Author(s):  
Dheeraj Goyal ◽  
Kristin Dascomb ◽  
Peter S Jones ◽  
Bert K Lopansri
Keyword(s):  
Risk Factors ◽  
Urinary Tract ◽  
Urinary Catheter ◽  
Univariate Analysis ◽  
Prior History ◽  
Factors Associated ◽  
Extended Spectrum ◽  
History Of ◽  
Enterobacteriaceae Infections ◽  
Tract Infections

Abstract Background Community-acquired extended-spectrum β-lactamase (ESBL) producing Enterobacteriaceae infections pose unique treatment challenges. Identifying risk factors associated with ESBL Enterobacteriaceae infections outside of prior colonization is important for empiric management in an era of antimicrobial stewardship. Methods We randomly selected 251 adult inpatients admitted to an Intermountain healthcare facility in Utah with an ESBL Enterobacteriaceae urinary tract infection (UTI) between January 1, 2001 and January 1, 2016. 1:1 matched controls had UTI at admission with Enterobacteriaceae but did not produce ESBL. UTI at admission was defined as urine culture positive for > 100,000 colony forming units per milliliter (cfu/mL) of Enterobacteriaceae and positive symptoms within 7 days prior or 2 days after admission. Repeated UTI was defined as more than 3 episodes of UTI within 12 months preceding index hospitalization. Cases with prior history of ESBL Enterobacteriaceae UTIs or another hospitalization three months preceding the index admission were excluded. Univariate and multiple logistic regression techniques were used to identify the risk factors associated with first episode of ESBL Enterobacteriaceae UTI at the time of hospitalization. Results In univariate analysis, history of repeated UTIs, neurogenic bladder, presence of a urinary catheter at time of admission, and prior exposure to outpatient antibiotics within past one month were found to be significantly associated with ESBL Enterobacteriaceae UTIs. When controlling for age differences, severity of illness and co-morbid conditions, history of repeated UTIs (adjusted odds ratio (AOR) 6.76, 95% confidence interval (CI) 3.60–13.41), presence of a urinary catheter at admission (AOR 2.75, 95% CI 1.25 – 6.24) and prior antibiotic exposure (AOR: 8.50, 95% CI: 3.09 – 30.13) remained significantly associated with development of new ESBL Enterobacteriaceae UTIs. Conclusion Patients in the community with urinary catheters, history of recurrent UTIs, or recent antimicrobial use can develop de novo ESBL Enterobacteriaceae UTIs. Disclosures All authors: No reported disclosures.

scholarly journals Extended-spectrum beta-lactamase-producing community-acquired urinary tract infections in children: Chart review of risk factors

2018 ◽  
Vol 10 (4) ◽  
pp. 222 ◽  
Author(s):  
Sundaram Balasubramanian ◽  
Dhanalakshmi Kuppuswamy ◽  
Swathi Padmanabhan ◽  
Vaishnavi Chandramohan ◽  
Sumanth Amperayani
Keyword(s):  
Risk Factors ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Chart Review ◽  
Beta Lactamase ◽  
Extended Spectrum Beta Lactamase ◽  
Extended Spectrum ◽  
Tract Infections

Epidemiology, risk factors and comorbidity for urinary tract infections caused by extended-spectrum beta-lactamase (ESBL)-producing enterobacteria

2012 ◽  
Vol 66 (9) ◽  
pp. 891-896 ◽  
Author(s):  
L. S. Briongos-Figuero ◽  
T. Gómez-Traveso ◽  
P. Bachiller-Luque ◽  
M. Domínguez-Gil González ◽  
A. Gómez-Nieto ◽  
...  
Keyword(s):  
Risk Factors ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Beta Lactamase ◽  
Extended Spectrum Beta Lactamase ◽  
Extended Spectrum ◽  
Tract Infections

scholarly journals Nosocomial urinary tract infections caused by extended-spectrum beta-lactamase uropathogens: Prevalence, pathogens, risk factors, and strategies for infection control

2016 ◽  
Vol 10 (3-4) ◽  
pp. 87 ◽  
Author(s):  
Khaireddine Bouassida ◽  
Mehdi Jaidane ◽  
Olfa Bouallegue ◽  
Ghassen Tlili ◽  
Habiba Naija ◽  
...  
Keyword(s):  
Risk Factors ◽  
Regression Analysis ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Multivariate Regression Analysis ◽  
Beta Lactamase ◽  
Extended Spectrum Beta Lactamase ◽  
Bladder Irrigation ◽  
Extended Spectrum ◽  
Tract Infections

Introduction: Our goal was to investigate the prevalence and antibiogram pattern of extended spectrum beta-lactamase (ESBL) production among uropathogens using isolates from urine samples collected at the Department of Urology in the Sahloul Hospital, Tunisia We also aimed to identify the risk factors for nosocomial urinary tract infections (UTIs) in patients who underwent transurethral resection of the prostate (TURP) and the measures for infection control.Methods: Laboratory records of a five-year period from January 2004 to December 2008 were submitted for retrospective analysis to determine the incidence of ESBL infections. A total of 276isolates were collected. A case-control study involving comparisons between two groups of patients who underwent TURP was performed to determine the risk factors for ESBL infection. Group 1, designated case subjects, included 51 patients with nosocomial UTI after TURP. Group 2, designated control subjects, consisted of 58 randomly selected patients who underwent TURP without nosocomialUTI in the same period. Factors suspected to be implicated in the emergence of ESBL infection were compared between the two groups in order to identify risk factors for infection. A univariate regression analysis was performed, followed by a multivariate one.Results: The annual prevalence of ESBL infection ranged from 1.3‒2.5%. After performing univariate and multivariate regression analysis, the main risk factors for ESBL infections were identified as: use of antibiotics the year preceding the admission, duration of catheter use, and bladder washout (p=0.012, p=0.019, and p<0.001.Conclusions: Urologists have to perform a good hemostasis, especially in endoscopic resections, in order to avoid bladder irrigation and bladder washout and to reduce the time of bladder catheterization, which is a strong risk factor of nosocomial UTIs.

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