Risk factors for community-acquired urinary tract infection due to quinolone-resistant E. coli.

Abstract

BACKGROUND:

Resistance to fluoroquinolone drugs is emerging among E. coli causing community acquired urinary tract infections (COMA-UTI).

OBJECTIVES:

To evaluate demographic and clinical risk factors associated with COMA-UTI due to quinolone-resistant E. coli (QREc).

METHODS:

In this case-control study, clinical and demographic data from 300 COMA-UTI due to E. coli (including 150 QREc) were analyzed.

RESULTS:

By univariate analysis QREc was associated to males, older patients, nursing home residents, functionally dependent, dementia, diabetes, cardiovascular diseases, immunosupression, nephrolithiasis, recurrent UTI, invasive procedures, hospitalization, and antibiotic use within previous 6 months. By multivariate analysis, use of ciprofloxacin (OR 20.6 [CI 2.3-179.2], p=0.006) or ofloxacin (OR 7.5 [CI 2.9-19.4], p<0.0001), previous invasive procedure (OR 6.6 [CI 3.0-14.7], p<0.0001), recurrent UTI (OR 4.7 [CI 2.3-9.3], p<0.0001), and previous hospitalization (OR 2.9 [CI 1.4-6], p=0.003) were identified as independent risk factors for COMA-UTI due to QREc.

CONCLUSION:

In patients with one or more of the risk factors identified here, the empiric use of quinolones should be reconsidered.

• Authors: R Colodner, I Kometiani, B Chazan, R Raz
• Journal: Infection (Infection) Vol. 36 Issue 1 Pg. 41-5 (Feb 2008) ISSN: 0300-8126 [Print] Germany
• PMID: 18193386 (Publication Type: Journal Article)

Chemical References

• Anti-Bacterial Agents
• Quinolones

Topics

• Adult
• Aged
• Aged, 80 and over
• Analysis of Variance
• Anti-Bacterial Agents (pharmacology, therapeutic use)
• Case-Control Studies
• Community-Acquired Infections (drug therapy, epidemiology, microbiology)
• Drug Resistance, Bacterial
• Escherichia coli (drug effects)
• Escherichia coli Infections (drug therapy, epidemiology, microbiology)
• Female
• Humans
• Male
• Middle Aged
• Quinolones (pharmacology, therapeutic use)
• Risk Factors
• Urinary Tract Infections (drug therapy, epidemiology, microbiology)