Supervisor：Ministry of Education of the People's Republic of ChinaSponsor：Sichuan University Editor-in-chief：LI Youping Publishing period：
Monthly
ISSN：1672-2531CN：51–1656/R
Objective To explore the risk factors of community-acquired urinary tract infections caused by extended-spectrum β-lactamase-producing Escherichia coli (ESBLs-producing Escherichia coli).
Methods Prospective and retrospective investigation methods were combined, to investigate the hospitalized patients diagnosed with community-acquired urinary tract infections caused by ESBLs-producing Escherichia coli in the Second Affiliated Hospital of Fujian Medical University during July 2012 to December 2014. Statistical analysis was performed using SPSS 19.0 software. The potential risk factors were analyzed by chi-square test or Fisher exact probability method, then, factors with statistical significance identified by single factor analysis were further analyzed by non-conditional logistic regression.
Results A total of 106 patients were included and divided into a ESBLs group (68 cases) and a control group (38 cases) according to the drug sensitivity test results. The results of single factor analysis indicated: there were significant differences between the ESBLs group and the control group in the use of antibiotics within three months before admission (χ2=11.292, P=0.001), the use of third generation cephalosporin (χ2=11.033, P=0.001), more than three kinds of diseases that could cause urinary tract obstruction (χ2=16.464, P=0.000), anemia (χ2=5.956, P=0.015), indwelling catheter (χ2=6.695, P=0.010), urinary system operations (χ2=9.730, P=0.002). The results of further non-conditional logistic regression analysis showed that more than three kinds of diseases that could cause urinary tract obstruction (OR=14.675, 95%CI 2.699 to 79.796, P=0.002), anemia (OR=7.976, 95%CI 1.785 to 35.632, P=0.007), the use of antibiotics within three months before admission (OR=7.057, 95%CI 1.597 to 31.175, P=0.010), the use of third generation cephalosporin (OR=6.344, 95%CI 1.145 to 35.146, P=0.034) and indwelling catheter (OR=3.844, 95%CI 1.058 to 13.967, P=0.041) were independent risk factors of community-acquired urinary tract infections caused by ESBLs-producing Escherichia coli.
Conclusion The risk factors of community-acquired urinary tract infections caused by ESBLs-producing Escherichia coli include more than three kinds of diseases that could cause urinary tract obstruction, anemia, the use of antibiotics within three months before admission, the use of third generation cephalosporin, and indwelling catheter. The use of antibiotics, especially the third generation cephalosporin, should be strictly controlled, the time of indwelling catheter should be reduced, and the anemia should be corrected, in order to reduce the incidence of community-acquired urinary tract infections caused by ESBLsproducing Escherichia coli.
Citation：CHENXia-rong, ZHANGHua-ping, ZENGXiu-yu, HUANGDong-hong, PANShao-min. Risk Factors Analysis of Community-acquired Urinary Tract Infections Caused by Extended-spectrum β-lactamase-producing Escherichia coli. Chinese Journal of Evidence-Based Medicine, 2016, 16(2): 125-129. doi: 10.7507/1672-2531.20160022Copy
Copyright ? the editorial department of Chinese Journal of Evidence-Based Medicine of West China Medical Publisher. All rights reserved
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8. Azap OK, Arslan H, Serefhano?lu K, et al. Risk factors for extendedspectrum β-lactamase positivity in uropathogenic Escherichia coli isolated from community-acquired urinary tract infections. Clin Microbiol Infect, 2010, 16(2):147-151.
9. Mava Y, Ambe JP, Bello M, et al. Evaluation of the nitrite test in screening for urinary tract infection in febrile children with sickle cell anaemia in Maiduguri-Nigeria. Niger Med J, 2011, 52(1):45-48.
11. Emiru T, Beyene G, Tsegaye W, et al. Associated risk factors of urinary tract infection among pregnant women at Felege Hiwot Referral Hospital, Bahir Dar, North West Ethiopia. BMC Res Notes, 2013, 6:292.
12. Mendelson G, Hait V, Ben-Israel J, et al. Prevalence and risk factors of extended spectrum beta-lactamase producing Escherichia coli and Klebsiella pneumoniae in an Israeli long-term care facility. Eur J Clin Microbiol Infect Dis, 2005, 24(1):17-22.
13. Muvunyi CM, Masaisa F, Bayingana C, et al. Decreased susceptibility to commonly used antimicrobial agents in bacterial pathogens isolated from urinary tract infections in Rwanda:need for new antimicrobial guidelines. Am J Trop Med Hyg, 2011, 84(6):923-928.
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