A case-control study of risk factors of nosocomial urinary tract infection due to ESBLs-producing Escherichia coli and the measures for intervention

Abstract

Objective To explore the risk factors and control effects of nosocomial urinary tract infection due to ESBLs-producing Escherichia coli.Methods 46 patients with nosocomial urinary tract infection due to ESBLs-producing Escherichia coli were assigned to the study group,and another 46 patients with the same urinary tract infection not due to ESBLs-producing Escherichia coli were assigned to the control group.A case-control study was conducted.Conditional logistic regression was used to screen the risk factors of nosocomial urinary tract infection due to ESBLs-producing Escherichia coli; and the corresponding control techniques were applied to assess the results of infection control prospectively.Results Longer length of hospital stay,uses of indwelling urinary tube,early use of the third generation cephalosporin,and use of multiple antibacterials (≥ 3 types) had a statistical significance by univariate and multi-univariate analysis.After the corresponding control measures were taken,the detection rate of ESBLs-producing strains of Escherichia coli declined from 57％ in 2011 to 31％ in 2012.Conclusions Longer length of hospital stays,use of indwelling urinary tube,early use of the third generation cephalosporin,and use of multiple antibacterials (≥ 3 types) are the independent risk factors for nosocomial urinary tract infection due to ESBLs-producing Escherichia coli.Strengthened awareness of ESBLs-producing strains,termination of transmission route,strict control of broad-spectrum antibiotic uses,correct placement of urinary tube,and shorter length of hospital stay are effective measures for controlling nosocomial urinary tract infection due to ESBLs-producing Escherichia coli. Key words: Urinary tract; ESBLs-producing Escherichia coli; Nosocomial infection; Risk factors; Case-control; Intervenion measures