scholarly journals 1434. Risk Factors for Community-Acquired Urinary Tract Infections Caused by Extended-Spectrum β-Lactamase (ESBL) Producing Escherichia coli in Children: A Case–Control Study

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S523-S524
Author(s):  
Frank Zhu ◽  
Rodado Maria ◽  
Basim Asmar ◽  
Hossein Salimnia ◽  
Ronald Thomas ◽  
...  
Keyword(s):  
Risk Factors ◽  
Escherichia Coli ◽  
Case Control Study ◽  
Case Control ◽  
Antibiotic Usage ◽  
Ethnic Background ◽  
E Coli ◽  
Tract Infections ◽  
Control Study

Abstract Background In recent years, there has been an increasing incidence of community-acquired urinary tract infections (UTI) caused by extended-spectrum β-lactamase (ESBL) producing Escherichia coli. However, the risk factors of ESBL-producing bacteria in community-acquired (CA)-UTI in children in the USA remain unclear. Methods A retrospective case–control study of UTI due to CA-ESBL-producing E. coli during a 5-year period (2011–2016) was performed. Control cases of non-ESBL-producing E. coli UTI were matched by age, gender, and year of infection. Medical records were manually reviewed to collect data for potential risk factors for ESBL-positive infection. Results A total of 111 patients with ESBL-producing E coli UTI and 103 control patients were included. The proportion of ESBL-producing E coli UTI ranged from 7% to 15% per year. The median age was 4 years with female predominance (84%). The ESBL group was predominantly African American (32%) followed by patients of Middle Eastern (ME) ethnic background (31%). Risk factors by univariate analysis were vesicoureteral reflux (VUR): (20.9 ESBL group vs. 6% controls; P = 0.002), prior antibiotic usage in the previous 3 months (including β-lactams), prior UTI (last 3 months), recent hospitalization (last 3 months) and ME ethnic background. However, multivariate analysis showed that only prior antibiotic usage (P = 0.001) and ME ethnic background (P < 0.001) remained statistically significant. 18% (11/60) of patients exposed to prior antibiotic use in the ESBL group were on long-term antibiotic prophylaxis for VUR. Conclusion Risk factors for CA-ESBL-producing E coli UTI in children were: (1) antibiotic usage within the previous 3 months and (2) ME background. Prior antibiotic usage as a risk factor reinforces the need for judicious use of antibiotics. The high percentage of patients in this group (18%) receiving long-term antibiotic prophylaxis for VUR warrants further study as this practice may increase the prevalence of ESBL-producing infections in a population at high risk for UTI. The increased risk among children of ME ethnic background warrants further study to evaluate possible additional associated risk factors such as recent international travel or contact with international travelers. Disclosures All authors: No reported disclosures.

scholarly journals Risk Factors for Infection with Escherichia coli in Nursing Home Residents Colonized with Fluoroquinolone-Resistant E. coli

2015 ◽  
Vol 36 (5) ◽  
pp. 575-577 ◽  
Author(s):  
Sara Manning ◽  
Ebbing Lautenbach ◽  
Pam Tolomeo ◽  
Jennifer H. Han
Keyword(s):  
Risk Factors ◽  
Escherichia Coli ◽  
Nursing Home ◽  
Case Control Study ◽  
Urinary Catheter ◽  
Nursing Home Residents ◽  
Case Control ◽  
Clinical Infection ◽  
E Coli ◽  
Control Study

A case-control study to determine risk factors for clinical infection with Escherichia coli was conducted among nursing home residents colonized with fluoroquinolone-resistant E. coli. Among 94 subjects, 11 (12%) developed infections with E. coli. Risk factors included the presence of a urinary catheter or tracheostomy, diabetes mellitus, and trimethoprim-sulfamethoxazole exposure.Infect Control Hosp Epidemiol 2015;00(0): 1–3

Multiresistant E. coli urine infections in children: a case–control study

2017 ◽  
Vol 103 (4) ◽  
pp. 336-340 ◽  
Author(s):  
Gayathri Raman ◽  
Brendan McMullan ◽  
Peter Taylor ◽  
Kylie-Ann Mallitt ◽  
Sean E Kennedy
Keyword(s):  
Risk Factors ◽  
Medical Records ◽  
Case Control Study ◽  
Significant Risk ◽  
Case Control ◽  
Patient Specific ◽  
E Coli ◽  
First Case ◽  
Tract Infections ◽  
Control Study

ObjectiveUrinary tract infections (UTIs) caused by resistant organisms are increasing which poses challenges when selecting empirical antimicrobial therapy. The aim of this study is to determine risk factors for multiresistant Escherichia coli UTIs in children.DesignWe included all reported urinary isolates from a children’s hospital collected between January 2010 and June 2013. Patients who had multiresistant E. coli UTIs were identified and a retrospective review of medical records performed. Patient-specific clinical and demographic factors were compared with age-matched and gender-matched controls with non-multiresistant E. coli UTIs. Univariable and multivariable statistical analysis were performed to determine significant risk factors for multiresistant organism E.coli UTIs.ResultsIn total, there were 2692 positive urine cultures, 1676 (62.3%) from 1169 patients were E. coli. Multiresistant E. coli was isolated from 139 (8.3% of all E. coli) cultures in 99 patients. Thirteen incomplete medical records were excluded, leaving 86 patients, matched with 86 controls. In multivariable regression, the only significant risk factor was antibiotic use in the previous month (adjusted OR 3.0, 95% CI 1.4 to 6.2), but not previous hospital admission (adjusted OR 1.4, 95% CI 0.6 to 2.9), being an inpatient at the time of diagnosis (adjusted OR 2.4, 95% CI 0.8 to 7.4) and previous instrumentation (adjusted OR 1.0, 95% CI 0.4 to 2.4).ConclusionsThis is the first case–control study to examine multiresistant UTI in Australian children. Clinicians should be judicious in the use of antibiotics in treatment and prophylaxis of UTIs. In children presenting with UTI and recent antibiotic exposure, amoxicillin-clavulanic acid appears to be an appropriate empiric antibiotic choice in our population.

scholarly journals Risk factors for Escherichia coli bacteraemia: a population-based case-control study

The Lancet ◽  
2017 ◽  
Vol 390 ◽  
pp. S85 ◽  
Author(s):  
Jiao Song ◽  
Angharad Walters ◽  
Damon Berridge ◽  
Ashley Akbari ◽  
Meirion Evans ◽  
...  
Keyword(s):  
Risk Factors ◽  
Escherichia Coli ◽  
Case Control Study ◽  
Population Based ◽  
Case Control ◽  
Control Study

scholarly journals Risk factors and outcomes of carbapenem-nonsusceptible Escherichia coli bacteremia: A matched case–control study

2011 ◽  
Vol 44 (2) ◽  
pp. 125-130 ◽  
Author(s):  
Hong-Jyun Chang ◽  
Po-Chang Hsu ◽  
Chien-Chang Yang ◽  
An-Jing Kuo ◽  
Ju-Hsin Chia ◽  
...  
Keyword(s):  
Risk Factors ◽  
Escherichia Coli ◽  
Case Control Study ◽  
Case Control ◽  
Matched Case ◽  
Matched Case Control Study ◽  
Control Study

scholarly journals Escherichia coli O157:H7 outbreak linked to salami, British Columbia, Canada, 1999

2004 ◽  
Vol 132 (2) ◽  
pp. 283-289 ◽  
Author(s):  
D. M. MacDONALD ◽  
M. FYFE ◽  
A. PACCAGNELLA ◽  
A. TRINIDAD ◽  
K. LOUIE ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Case Control Study ◽  
Meat Products ◽  
Case Control ◽  
Pfge Pattern ◽  
Escherichia Coli O157 ◽  
E Coli ◽  
Matched Case ◽  
Matched Case Control Study ◽  
Control Study

An outbreak of E. coli O157:H7 infections was identified in November 1999 with a fivefold increase in the occurrence of laboratory-confirmed cases of E. coli O157:H7 infection. A matched case-control study was conducted. Samples of food from cases and from retailers were analysed for the presence of E. coli O157:H7. A total of 143 cases were identified over a 12-week period with the same pulsed-field gel electrophoresis (PFGE) pattern. The case-control study found that Company A salami was significantly associated with illness (Mantel–Haenszel matched odds ratio 10·0, 95% CI 1·4–434, P=0·01). Company A salami tested positive for E. coli O157:H7 and isolates had the same PFGE pattern as case isolates. An immediate voluntary national recall of Company A dry fermented meat products took place. Findings from the investigation of this outbreak suggest that the hold-and-test option may not be adequate to prevent shiga-toxigenic Escherichia coli (STEC) infection in salami consumers.

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