Urinary tract infection caused by extended‐spectrum β‐lactamase‐producing bacteria: Risk factors and antibiotic resistance

Abstract

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. 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. A total of 243 patients with community-acquired UTI in a 5year 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 ± 5.5days vs 8.0 ± 4.4days, P=0.013). Significant potential risk factors for ESBL-UTI were previous use of antibiotics in the last 3months, previous hospitalization in the last 3months, history of recurrent UTI, and presence of renal anomalies. On logistic regression analysis, history of previous hospitalization in the last 3months (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. Recognizing the risk factors for ESBL-UTI helps to identify the high-risk cases and enables proper management.