Urinary tract infection caused by extended-spectrum β-lactamase-producing bacteria: Risk factors and antibiotic resistance.
BACKGROUND
The aim of this study was to investigate the risk factors for acquisition of extended spectrum β-lactamase (ESBL)-producing bacteria in community-acquired urinary tract infection (UTI) and to evaluate their antimicrobial resistance.


METHODS
The medical records of hospitalized children were retrospectively evaluated. Children with ESBL-producing bacteria UTI were matched with controls with non-ESBL-producing bacteria UTI of the same age and gender.


RESULTS
A total of 243 patients with community-acquired UTI in a 5 year period were evaluated, of whom 46% had UTI caused by ESBL bacteria. Seventy-seven cases were matched with 77 controls. There were no significant differences in the clinical presentation between the two groups apart from a longer hospital stay in the ESBL group (9.1 ± 5.5 days vs 8.0 ± 4.4 days, P = 0.013). Significant potential risk factors for ESBL-UTI were previous use of antibiotics in the last 3 months, previous hospitalization in the last 3 months, history of recurrent UTI, and presence of renal anomalies. On logistic regression analysis, history of previous hospitalization in the last 3 months (OR, 3.83; 95%CI: 1.49-9.84) was identified as an independent significant risk factor for ESBL-UTI. There was a significantly higher resistance to amoxicillin-clavulanate, amikacin, gentamycin and quinolones in the ESBL group compared with the control group.


CONCLUSION
Recognizing the risk factors for ESBL-UTI helps to identify the high-risk cases and enables proper management.
['Albaramki|Jumana H|JH|https://orcid.org/0000-0001-5917-0379', 'Abdelghani|Tariq|T|', 'Dalaeen|Alaa|A|', 'Khdair Ahmad|Fareed|F|', 'Alassaf|Abeer|A|', 'Odeh|Rasha|R|', 'Akl|Kamal|K|']
D000293:Adolescent D000900:Anti-Bacterial Agents D016022:Case-Control Studies D002648:Child D002675:Child, Preschool D017714:Community-Acquired Infections D004352:Drug Resistance, Microbial D004926:Escherichia coli D004927:Escherichia coli Infections D005260:Female D005500:Follow-Up Studies D006801:Humans D015994:Incidence D007223:Infant D007231:Infant, Newborn D007597:Jordan D008297:Male D008826:Microbial Sensitivity Tests D012189:Retrospective Studies D018570:Risk Assessment D012307:Risk Factors D014552:Urinary Tract Infections D001618:beta-Lactamases
urinary tract infection risk factors antimicrobial resistance hospitalization extended spectrum β-lactamase-producing bacteria