부산대학교 도서관

Aim: The incidence of urinary tract infections (UTIs) due to extended-spectrum ß-lactamase (ESBL)-producing Escherichia coli is increasing worldwide. Infections with ESBL-producing E. coli are associated with prolonged length of hospital stay, cost, and need for parenteral therapy. This study was aimed to describe the prevalence and assess the risk factors of UTIs due to ESBL-producing E. coli and to describe the antimicrobial susceptibility patterns against E. coli. Methods: A retrospective, cross-sectional study was conducted at King Saud University Medical City from May 1, 2015, to May 1, 2016, and included all adult cases of UTIs caused by E. coli.Results: E. coli urine isolates were obtained from 301 patients; 107 (35.5%) isolates had ESBL-producing E. coli, and 194 (64.5%) had non-ESBL E. coli. On multivariate analysis, urinary catheterization (odds ratio [OR] 1.4, 95% confidence interval [CI] 1.17–1.55, P < 0.00), antibiotic use in the past 3 months, (OR 1.3, 95% CI 1.16–1.4, P < 0.00), and diabetes mellitus (OR 1.2, 95% CI 1.04–1.31, P < 0.00) were significantly associated with ESBL-producing E. coli. infection. As expected, these ESBL producing isolates demonstrated higher resistance compared to non-ESBL E. coli to trimethoprim/sulfamethoxazole (64.5% vs. 43.8%), ciprofloxacin (64.4% vs. 28.7%), and gentamycin (36.4% vs. 9.2%). Conclusion: About one-third of UTI patients with E. coli presented with ESBL-producing bacteria. Significant risk factors were urinary catheterizations, history of antibiotic use, and diabetes mellitus. However, the associated OR was low for all predictors indicating their limited value in identifying patients at risk of ESBL.