Epidemiological factors associated with ESBL- and non ESBL-producing E. coli causing urinary tract infection in general practice

Abstract

The purpose of the study was to evaluate how use of antibiotics precedes the presence of ESBL-producing E.coli in general practice. The authors performed a triple-case-control study where three case groups were individually compared to a single control group of uninfected individuals. Urine samples were prospectively collected and retrospective statistical analyses were done. This study included 98 cases with urinary tract infection (UTI) caused by ESBL-producing E. coli, 174 with antibiotic-resistant (non-ESBL) E. coli, 177 with susceptible E. coli and 200 with culture negative urine samples. Case groups had significantly higher use of antibiotics than the control group within 30 days before infection (p < 0.0001). The ESBL group had significantly more hospital admissions than the other case groups (p < 0.05). Hospital admission was an independent risk factor for community onset UTI by ESBL-producing E. coli. Exposure to antibiotics was a risk factor for UTI with E. coli, while prior antibiotic usage was not an indisputable predictor for infection with ESBL-producing E.coli in general practice.

Keywords:

• UTI
• Escherichia coli
• risk factors
• community-acquired
• ESBL

Acknowledgements

The authors wish to thank statistician Steen Ladelund for assistance with the statistical analyses. The study was performed in cooperation between HVH, Roskilde University and University of Copenhagen. This work was, in parts, presented at ECCMID in Berlin 2013 and at ICAAC, Denver, CO, 2013. This work was supported by the EU-FP funded project PAR7, DanCARD (Danish National Strategic Research Foundation, project 09-067075/DSF), and the SSAC Foundation (SLS-327421 and SLS-251761).

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.