Epidemiology Research Today is a free monthly online journal that collates and summarizes the latest research about Epidemiology, including details on twin studies, statistics, environmental and genetic factors.

Epidemiology of urinary tract infections caused by extended-spectrum beta-lactamase-producing Escherichia coli.

Ena J, Arjona F, Martínez-Peinado C, López-Perezagua Mdel M, Amador C

Department of Internal Medicine, Hospital Marina Baixa, Villajoyosa, Alicante, Spain. ena_jav@gva.es

OBJECTIVES: To describe the epidemiology of urinary tract infections caused by extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli. METHODS: We performed three studies: a trend study (1999 to 2004) to assess the evolution and origin of ESBL-producing E. coli isolates from urine samples; a comparison of the susceptibility patterns of ESBL-producing E. coli and a random sample of non-ESBL-producing E. coli isolated in the same interval, and a retrospective chart review to determine the risk factors for acquisition of, and outcomes from, urinary tract infections caused by ESBL-producing E. coli (n = 61) compared with a random sample of non-ESBL-producing E. coli urinary tract infections (n = 61) from patients attending our institution and matched by temporal occurrence. RESULTS: ESBL-producing E. coli significantly increased from 2 (0.20%) to 89 (5.52%) isolates per year (P value for trend = 0.000). Of the 161 patients with urinary tract infections caused by ESBL-producing E. coli, 100 (62%) were attending ambulatory health centers, and 61 (38%) were attending the hospital. ESBL-producing E. coli showed a significant reduction in the susceptibility to most antimicrobials, although carbapenems and fosfomycin retained significant activity. The chart review study showed that previous treatment with fluoroquinolones (odds ratio 12.98, 95% confidence interval 1.81 to 106.51, P = 0.017) and the presence of a urinary catheter (odds ratio 2.64, 95% confidence interval 1.01 to 6.88, P = 0.047) were independent risk factors associated with infections caused by ESBL-producing E. coli. CONCLUSIONS: ESBL-producing E. coli is a problem of increasing importance. Our study results may help physicians select appropriate antimicrobial therapy in patients suspected of having urinary tract infections caused by ESBL-producing E. coli.

Published 15 December 2006 in Urology, 68(6): 1169-74.
Full-text of this article is available online (may require subscription).

© 2005-2008 Epidemiology Research Today. All Rights Reserved.