Risk factors associated with a cluster of urinary tract infections in a geriatric unit caused by Klebsiella pneumoniae resistant to multiple antibiotics

Background: High rates of amoxicillin-clavulanate (AMC) resistance among Enterobacterales isolated from urinary tract infections (UTIs) were observed in our area. The aim of this study was to identify risk factors associated with AMC resistance in patients with community-onset UTI in emergency departments (EDs). Methods: A retrospective study was performed of all ED patients with positive urine cultures for Escherichia coli or Klebsiella pneumoniae in a Spanish tertiary-care hospital. Results: 330 urine cultures in all were included: 261 (79.1%) for E. coli and 69 (20.90%) for K. pneumonia. Rates of AMC resistance were 14.94% and 34.78%, respectively. UTI was clinically confirmed in 212 (64.24%) cases. Previous antimicrobial exposure was independently associated with AMC resistance development in E. coli and K. pneumoniae urinary isolates (OR = 2.94, 95% CI = 1.55–5.58). Analyses of infected patients revealed that previous exposure to fluoroquinolones (OR = 3.33, 95% CI = 1.10–10.12, p = 0.034) and to AMC (OR = 5.68, 95% CI = 1.97–16.44, p = 0.001) was significantly associated with isolation of AMC-resistant strains. Conclusions: Prior antibiotic exposure, particularly to AMC or fluoroquinolones, was the only independent risk factor associated with development of AMC resistance in E. coli and K. pneumoniae urinary isolates from patients attending the ED.

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Risk Factors Associated with Community-Acquired Urinary Tract Infections Caused by Extended-Spectrum β-Lactamase-Producing Escherichia coli: a Systematic Review

Current Epidemiology Reports ◽

10.1007/s40471-019-00206-4 ◽

2019 ◽

Vol 6 (3) ◽

pp. 300-309 ◽

Cited By ~ 3

Author(s):

Cheyenne R. Butcher ◽

Julia Rubin ◽

Kaitlyn Mussio ◽

Lee W. Riley

Keyword(s):

Risk Factors ◽

Escherichia Coli ◽

Systematic Review ◽

Urinary Tract ◽

Urinary Tract Infections ◽

Factors Associated ◽

Extended Spectrum ◽

Tract Infections

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Factors associated with nosocomial urinary tract infections in maternity wards of public hospitals in Lubumbashi in DR Congo

Archives of Infectious Diseases & Therapy ◽

10.33140/aidt.05.02.01 ◽

2021 ◽

Vol 5 (2) ◽

Keyword(s):

Risk Factors ◽

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

Urinary Tract Infections ◽

Public Hospitals ◽

Hospital Environment ◽

Factors Associated ◽

Nosocomial Urinary Tract Infection ◽

Tract Infections

Introduction: Nosocomial urinary tract infection represents between 30 and 50% of all these nosocomial infections. It occupies the first place and constitutes the third entry point for bacteremia. The objective of our study was to identify the risk factors associated with nosocomial urinary tract infections in maternity wards of public hospitals in Lubumbashi. Method: We carried out an analytical cross-sectional study in which the population consisted of parturients who did not have a urinary tract infection on admission. The urine samples were taken and analyzed in the laboratory of the university clinics of Lubumbashi. A case of nosocomial urinary tract infection was defined according to the WHO definition. To collect this urine, the parturients did it themselves after a health education session. Two samples were taken, one at the entry and the other at the exit of the parturient from the maternity hospital. The univariate analysis used the prevalence ratio as an indicator of risk with a 95% confidence interval and the bivariate analysis included all risk factors that had a significance level p ˂ 0.05 by a regression model binary logistics. Results: Out of the total of 1240 parturients selected and who were distributed in seven maternities of public hospitals in the city of Lubumbashi. It was noted that women who gave birth at HGR Kampemba were up to ten times more likely to develop nosocomial urinary tract infection than those who did at HGR Kisanga. An association was observed between delivery with complications (p = 0.032), long length of stay (p <0.001), delivery with surgical intervention (p <0.001) and antibiotic therapy (p = 0.020). Conclusion: Nosocomial urinary tract infections were varied depending on the characteristics of health structures, characteristics of parturients and health care. It is necessary to improve the hospital hygiene of the personnel, the hospital environment and the materials as well as a good policy of use of the antibacterials.

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