Key demographic characteristics of patients with bacteriuria due to extended spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae in a multiethnic community, in North West London

Abstract

Background: Infections with extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBLE) are encountered worldwide, particularly in certain regions of the world and in certain ethnic groups. Simple criteria for identification of patients likely to be infected with ESBLE may enable clinicians to select appropriate empirical antibiotics for treatment. The aim of this study was to explore the association between ESBLE bacteriuria and readily available key demographic characteristics (age, gender and ethnicity) in a multiethnic population. Methods: In this cross-sectional observational study, we explored the association between ESBLE bacteriuria and age, gender and ethnicity in 134 831 patients who submitted urine specimens for culture during 2007–2009 in two multiethnic boroughs in London, UK. Results: In multivariate analysis, the risk of ESBLE bacteriuria was higher in males (odds ratio, OR = 1.3) and in patients older than 60 years (OR > 2). Patients from an Asian ethnic group were significantly more likely than White British subjects to have ESBLE bacteriuria (Indians, OR = 2.7; Asians of any other background, OR = 2.4; and Pakistanis, OR = 1.8). In contrast, patients who were of white ethnic background other than Irish were 0.66 times less likely to have ESBLE bacteriuria than White British patients (p = 0.025). Conclusions: Our study shows that in our local multiethnic population, older patients (> 60 years), males and those of South Asian ethnicity were significantly more likely to have ESBLE bacteriuria than others. Knowledge of these simple and readily available demographic data can help identify groups of patients at risk of urinary tract infection (UTI) with ESBLE and may aid in choice of empirical antibiotics.