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

Ena, Javier; Arjona, Francisco J.; Martínez-Peinado, Carmen; López-Perezagua, María del Mar; Amador, Concepción

doi:10.1016/j.urology.2006.08.1075

Cited by 79 publications

(67 citation statements)

References 16 publications

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“…Previously ESBL producing E.coli was shown to be a problem in the hospital settings only, however the problem has been reported to be extending to community settings Paper as well [21]. Results of our study also show that it has become a problem even in the community.…”

Section: Discussionsupporting

confidence: 60%

Resistance and utilisation pattern of antibacterial agents in outpatient settings in two Teaching Hospitals in Colombo

et al. 2016

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Objectives Antibacterial resistance (ABR) is a public threat. Sri Lanka is a country with limited surveillance of ABR in the community. The WHO methodology was adapted to identify ABR in outpatient settings (nonhospitalised patients) and its link to consumption of antibiotics.Methods It was a cross-sectional descriptive community based study to collect ABR data from Out Patient Department (OPD) of two leading Teaching Hospitals in Colombo district. The indicator organism Escherichia coli (E. coli) was obtained from the urine specimens of patients who were suspected to have urinary tract infections. Antibiotic susceptibility testing was performed for commonly used oral antibiotics using disc diffusion method. The antibiotic consumption aggregate data were collected from the OPD pharmacies of the said hospitals and expressed as Defined Daily Doses (DDD) per 1000 inhabitants per 1000 day.Results Of the 2183 urine samples, pathogenic E. coli was isolated in 9.3% (204), and 8% (n=16) of them were Extended Spectrum Beta Lactamase (ESBL) producers. E.coli was most resistant to ampicillin (85%), followed by nalidixic acid (58.5%), trimethoprim/sulphamethoxazole (47.1%), ciprofloxacin (46.2%), norfloxacin (43.7%) amoxicillin /clavulanic acid (36.3%) and nitrofurantoin (15%). Multi-drug resistance was seen in 44%. Amoxicillin was the most frequently consumed antibacterial agent (2.65 DDD per 1000 inhabitants per day).Conclusions There is an alarmingly high antibiotic resistance in the non-hospitalised patients indicating high prevalence of E. coli resistance in the community.

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Section: Discussionsupporting

confidence: 60%

Resistance and utilisation pattern of antibacterial agents in outpatient settings in two Teaching Hospitals in Colombo

et al. 2016

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“…In most studies, the use of antibiotics in the preceding year is one of the strongest risk factors for developing ESBL infections. 13,[14][15][16]18,19,23 In our study, the use of antibiotic therapy in the year prior to hospital admission was a predictor of ESBL infection in the univariate analysis, but not an independent risk factor in the multivariate analysis.…”

Section: Discussioncontrasting

confidence: 52%

“…In fact, while several authors reported that age >65 years was predictor for ESBL infection, 13,14 others have not confirmed this. [15][16][17] In our study, 62% of patients were >60 years. Accordingly, age was not a risk factor, which could presumably be due to the selection bias.…”

Section: Discussionmentioning

confidence: 50%

“…15,16 The results of the present study revealed that during hospitalization, uncontrolled diabetes, chronic renal failure, and anemia are associated with the emergence of ESBL UTIs after performing univariate analysis; however, after multivariate analysis, they do not represent independent risk factors for ESBL infection.…”

Section: Discussionmentioning

confidence: 53%

“…13,16 Still other authors reported there is no significant difference between males and females. 15,20 Note that in our analytic study, all patients are male.…”

Section: Discussionmentioning

confidence: 99%

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

Bouassida¹,

Jaidane²,

Bouallègue³

et al. 2016

CUAJ

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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 276 isolates 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 nosocomial UTI 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. IntroductionHospital infections have become a growing healthcare challenge in recent decades and serious concerns have been expressed over the rise in antimicrobial resistance among pathogens causing hospital-acquired infections. Nosocomially acquired urinary tract infection (NAUTI) is one of the most common hospital-acquired infections. 2,3This infection is not already present or incubating at the time of admission, but is acquired during hospital stay. Its definition requires a 48-hour delay after admission before symptoms appear.1,4,5 NAUTI has become one of the most important quality parameters for urological surgery. The problem is further exacerbated by the emergence of drug resistance among uropathogens in the form of extended spectrum beta-lactamase (ESBL) production. In fact, the first outbreak of ESBL-producing organisms was reported in 1983 in Germany 1 and involved chromosomal-or plasmid-mediated beta-lactamases (enzymes that cleave the beta-lactam ring) that had mutated from pre-existing broad-spectrum beta-lactamases as a consequence of the extensive use of third-generation cephalosporins and aztreonam.6 Those ESBL-producing pathogens are now...

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Extraintestinal Pathogenic Escherichia coli

Biran

Ron

2018

Current Topics in Microbiology and Immunology

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Extraintestinal pathogenic E. coli (ExPEC) present a major clinical problem that has emerged in the past years. Most of the infections are hospital or community-acquired and involve patients with a compromised immune system. The infective agents belong to a large number of strains of different serotypes that do not cross react. The seriousness of the infection is due to the fact that most of the infecting bacteria are highly antibiotic resistant. Here, we discuss the bacterial factors responsible for pathogenesis and potential means to combat the infections.

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

Cited by 79 publications

References 16 publications

Resistance and utilisation pattern of antibacterial agents in outpatient settings in two Teaching Hospitals in Colombo

Resistance and utilisation pattern of antibacterial agents in outpatient settings in two Teaching Hospitals in Colombo

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

Extraintestinal Pathogenic Escherichia coli

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