Objective: The objective of this study was to determine the risk factors in community-acquired urinary tract infections (UTIs) caused by extended spectrum β-lactamase (ESBL)- producing Escherichia coli, and antibiotic resistance rates in these strains.
Methods: Patients who had been admitted to the Trakya University Health Center for Medical Research and Practice Infectious Diseases and Clinical Microbiology Department with the diagnosis of UTI from January 1, 2008 through January 1, 2018 and had E. coli growth in urine culture were analyzed retrospectively. Patients who had ESBL-positive E. coli growth in their urine cultures were the case group and patients with the ESBL-negative E. coli growth in their urine cultures were the control group.
Results: In the study, 379 UTI episodes were detected in 346 patients. There were 117 (30.9%) episodes in the case group and 262 (69.1%) episodes in the control group. In univariate analysis, young age (approximately 62±19.6 years in the case group, 68±19.4 years in the control group), malignancy in a solid organ, urinary pathologies, urinary catheterization, history of urological procedure in the last six months, history of hospitalization in the last three months, history of antibiotic use in the last three months and recurrent UTI were statistically significant for ESBL production (p<0.05). In multivariate analysis, malignancy in a solid organ (OR: 2.267; CI: 1.205-4.266; p=0.011), urinary catheterization (OR: 2.266; CI: 1.186-4.330; p=0.013), and antibiotic use in the last three months (OR: 5.050; CI: 3.038-8.395; p=0.000) were found to be the independent risk factors for ESBL production. Empirical treatment effectiveness rate was lower and hospital stay was longer in the case group. E. coli strains were found to have higher resistance rates to antibiotics other than fosfomycin and nitrofurantoin and they were not suitable for empirical treatment of UTIs.
Conclusions: Knowing the risk factors and antibiotic resistance rates in terms of ESBL production in the community patients will both increase the empirical treatment success of UTIs and reduce unnecessary antibiotic use.
Klimik Dergisi 2020; 33(1): 55-61.
Cite this article as: Kara M, Elmaslar-Mert HT, Kuloğlu F, Akata F. [Evaluation of risk factors in community acquired urinary tract infections caused by extended spectrum β-lactamase-producing Escherichia coli]. Klimik Derg. 2020; 33(1): 55-61. Turkish.