Risk factors for the development of extended-spectrum beta-lactamase-producing bacteria in nonhospitalized patients

Eur J Clin Microbiol Infect Dis. 2004 Mar;23(3):163-7. doi: 10.1007/s10096-003-1084-2. Epub 2004 Feb 19.

Abstract

Although the risk factors for acquiring infection by extended-spectrum beta-lactamase (ESBL)-producing bacteria have been investigated in hospitalized patients, such risk factors have not been defined in the community setting. In this study, clinical data from a total of 311 nonhospitalized patients with community-acquired urinary tract infection (128 with ESBL-positive strains and 183 with ESBL-negative strains) were obtained. According to a multivariate analysis, the following were identified as independent risk factors: previous hospitalization in the past 3 months (OR=8.95, 95%CI, 3.77-21.25), antibiotic treatment in the past 3 months (OR=3.23, 95%CI, 1.76-5.91), age over 60 years (OR=2.65, 95%CI, 1.45-4.83), diabetes (OR=2.57, 95%CI, 1.20-5.51), male gender (OR=2.47, 95%CI, 1.22-5.01), Klebsiella pneumoniae infection (OR=2.31, 95%CI, 1.17-4.54), previous use of third-generation cephalosporins (P=0.014, OR=15.8, 95%CI, 1.7-143), previous use of second-generation cephalosporins (P<0.0001, OR=10.1, 95%CI, 4.2-24), previous use of quinolones (P=0.001, OR=4.1, 95%CI, 1.8-9.0), and previous use of penicillin (P=0.003, OR=4.0, 95%CI, 1.6-9.0).

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Ambulatory Care
  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use
  • Child
  • Child, Preschool
  • Cohort Studies
  • Community-Acquired Infections / epidemiology
  • Community-Acquired Infections / microbiology
  • Drug Resistance, Bacterial
  • Escherichia coli / enzymology*
  • Escherichia coli / isolation & purification
  • Escherichia coli Infections / diagnosis
  • Escherichia coli Infections / drug therapy
  • Escherichia coli Infections / epidemiology*
  • Female
  • Humans
  • Incidence
  • Klebsiella / classification
  • Klebsiella / enzymology*
  • Klebsiella Infections / diagnosis
  • Klebsiella Infections / drug therapy
  • Klebsiella Infections / epidemiology*
  • Male
  • Microbial Sensitivity Tests
  • Middle Aged
  • Multivariate Analysis
  • Odds Ratio
  • Probability
  • Prognosis
  • Risk Factors
  • Sex Distribution
  • Statistics, Nonparametric
  • Urinary Tract Infections / drug therapy
  • Urinary Tract Infections / epidemiology*
  • Urinary Tract Infections / microbiology
  • beta-Lactamases / metabolism*

Substances

  • Anti-Bacterial Agents
  • beta-Lactamases