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Investigation of risk factors for community-acquired urinary tract infections caused by extended-spectrum beta-lactamase Escherichia coli and Klebsiella species

Investigative and Clinical Urology 2019년 60권 1호 p.46 ~ 53
 ( Koksal Eda ) - Samsun Training and Research Hospital Department of Infectious Diseases and Clinical Microbiology

 ( Tulek Necla ) - Health Sciences University Ankara Training and Research Hospital Department of Infectious Diseases and Clinical Microbiology
 ( Sonmezer Meliha Cagla ) - Hacettepe University Department of Infectious Diseases and Clinical Microbiology
 ( Temocin Fatih ) - Ondokuz Mayis University Department of Infectious Diseases and Clinical Microbiology
 ( Bulut Cemal ) - Gulhane Training and Researh Hospital Department of Infectious Diseases and Clinical Microbiology
 ( Hatipoglu Cigdem ) - Health Sciences University Ankara Training and Research Hospital Department of Infectious Diseases and Clinical Microbiology
 ( Erdinc Fatma Sebnem ) - Health Sciences University Ankara Training and Research Hospital Department of Infectious Diseases and Clinical Microbiology
 ( Ertem Gunay ) - Health Sciences University Ankara Training and Research Hospital Department of Infectious Diseases and Clinical Microbiology

Abstract


Purpose: The aim of this study was to determine the prevalence and risk factors for community-acquired urinary tract infections (CA-UTIs) caused by extended-spectrum β-lactamase (ESBL) producing Escherichia coli and Klebsiella species.

Materials and Methods: The patients diagnosed with CA-UTIs caused by E. coli or Klebsiella spp. were included in the study. All of the patients were compared to demographic characteristics, underlying diseases, urinary tract pathology, history of hospitalization, use of antibiotics according to ESBL positivity.

Results: A total of 322 urine isolates were studied. Sixty-six patients (37.1%) of a total of 178 patients were ESBL positive E. coli and Klebsiella spp. Being over the age of sixty (odds ratio [OR], 1.90; p=0.03), history of renal stone (OR, 3.00; p=0.03), urinary tract anatomical of physiological disorder (OR, 2.17; p=0.01), urologic intervention (OR, 3.43; p<0.001), history of urinary tract surgery (OR, 3.10; p=0.01), history of urinary catheterization (OR, 3.43; p<0.001), and hospitalization for last 1 year (OR, 3.70; p=0.01) and antibiotic usage in the last 3 months (OR, 1.90; p=0.04) were found as significant risk factors for the producing of ESBL. However, gender and underlying disease were not related for ESBL production.

Conclusions: In present study, high rate of ESBL positivity was detected in CA-UTIs. The increasing of infections caused by ESBL positive E. coli and Klebsiella spp. are bringing together a lot of the problem, such as antibiotic resistance and reducing treatment options for outpatients. Identification of underlying risk factors would be important for the development of preventive strategies.

키워드

Community-acquired urinary tract infections; Escherichia coli; Extended-spectrum beta-lactamase; Klebsiella species
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