Factors Associated with Acute Community-Acquired Pyelonephritis Caused by Extended-Spectrum β-Lactamase-Producing Escherichia coli

This study aimed to identify the factors associated with the presence of extended-spectrum ß-lactamase-(ESBL) in patients with acute community-acquired pyelonephritis (APN) caused by Escherechia coli (E. coli), with a view of optimising empirical antibiotic therapy in this context. We performed a re...

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Bibliographic Details
Published in:Journal of clinical medicine 2021-11, Vol.10 (21), p.5192
Main Authors: Romero Nieto, Mónica, Maestre Verdú, Sara, Gil, Vicente, Pérez Barba, Carlos, Quesada Rico, Jose Antonio, Pascual Pérez, Reyes
Format: Article
Language:English
Subjects:
Abscesses
Age
Antibiotics
Antimicrobial agents
Clinical medicine
Comorbidity
Confidence intervals
E coli
Enzymes
Hypertension
Microorganisms
Patients
Sepsis
Urinary incontinence
Urinary tract diseases
Urinary tract infections
Urine
Urogenital system
Variables
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Summary:This study aimed to identify the factors associated with the presence of extended-spectrum ß-lactamase-(ESBL) in patients with acute community-acquired pyelonephritis (APN) caused by Escherechia coli (E. coli), with a view of optimising empirical antibiotic therapy in this context. We performed a retrospective analysis of patients with community-acquired APN and confirmed E. coli infection, collecting data related to demographic characteristics, comorbidities, and treatment. The associations of these factors with the presence of ESBL were quantified by fitting multivariate logistic models. Goodness-of-fit and predictive performance were measured using the ROC curve. We included 367 patients of which 51 presented with ESBL, of whom 90.1% had uncomplicated APN, 56.1% were women aged ≤55 years, 33.5% had at least one mild comorbidity, and 12% had recently taken antibiotics. The prevalence of ESBL-producing E. coli was 13%. In the multivariate analysis, the factors independently associated with ESBL were male sex (OR 2.296; 95% CI 1.043–5.055), smoking (OR 4.846, 95% CI 2.376–9.882), hypertension (OR 3.342, 95% CI 1.423–7.852), urinary incontinence (OR 2.291, 95% CI 0.689–7.618) and recurrent urinary tract infections (OR 4.673, 95% CI 2.271–9.614). The area under the ROC curve was 0.802 (IC 95% 0.7307–0.8736), meaning our model can correctly classify an individual with ESBL-producing E. coli infection in 80.2% of cases.
ISSN:2077-0383
2077-0383
DOI:10.3390/jcm10215192