Urinary tract infections in older adults: associated factors for extended-spectrum beta-lactamase production

被引:1
作者
Alkan, Sena [1 ]
Balkan, Ilker Inanc [1 ]
Surme, Serkan [2 ]
Bayramlar, Osman Faruk [3 ]
Kaya, Sibel Yildiz [1 ]
Karaali, Ridvan [1 ]
Mete, Bilgul [1 ]
Aygun, Gokhan [1 ]
Tabak, Fehmi [1 ]
Saltoglu, Nese [1 ]
机构
[1] Istanbul Univ Cerrahpasa, Cerrahpasa Med Fac, Dept Infect Dis & Clin Microbiol, Istanbul, Turkiye
[2] Istanbul Univ Cerrahpasa, Inst Grad Studies, Dept Med Microbiol, Istanbul, Turkiye
[3] Bakirkoy Dist Hlth Directorate, Dept Publ Hlth, Istanbul, Turkiye
关键词
urinary tract infection; extended-spectrum beta-lactamase; Escherichia coli; Klebsiella pneumoniae; associated factors; GRAM-NEGATIVE BACILLI; RISK-FACTORS; ESCHERICHIA-COLI; KLEBSIELLA-PNEUMONIAE; UNITED-STATES; SUSCEPTIBILITY; ENTEROBACTERIACEAE; PREVALENCE; ORGANISMS; MORTALITY;
D O I
10.3389/fmicb.2024.1384392
中图分类号
Q93 [微生物学];
学科分类号
071005 ; 100705 ;
摘要
Objective: Urinary tract infections (UTIs) due to extended-spectrum beta-lactamase (ESBL) producing Escherichia coli and Klebsiella pneumoniae are among the leading causes of morbidity and mortality in older adults. Identifying associated factors for ESBL production may contribute to more appropriate empirical treatment. Materials and methods: This was a prospective observational study. Hospitalized patients of age > 65 with community-onset or hospital-acquired upper UTI due to E. coli or Klebsiella pneumoniae were included. A multivariate analysis was performed. Results: A total of 97 patients were included. ESBL prevalence among UTIs with E. coli or Klebsiella pneumoniae was 69.1% (n = 67). CRP values at the time of UTI diagnosis were found to be significantly higher in the ESBL-producing group (p = 0.004). The multivariate analysis revealed that male gender (OR: 2.72, CI: 1.02-7.25), prior recurrent UTI (OR: 3.14, CI: 1.21-8.14), and the development of secondary bacteremia (OR: 4.95, CI: 1.03-23.89) were major associated factors for UTI in older adults due to ESBL-producing E. coli and Klebsiella pneumoniae. Conclusion: Severe UTI in older men with a history of recurrent UTI may be a warning to the clinician for ESBL production in the setting of high ESBL prevalence. Carbapenems may be prioritized in the empirical treatment of patients with known risk factors for ESBL.
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