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Infection. 2008 Feb;36(1):41-5. doi: 10.1007/s15010-007-7083-y. Epub 2008 Jan 12.

Risk factors for community-acquired urinary tract infection due to quinolone-resistant E. coli.

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1
Clinical Microbiology Laboratory, Ha'Emek Medical Center, 18101, Afula, Israel. colodner_ra@clalit.org.il

Abstract

BACKGROUND:

Resistance to fluoroquinolone drugs is emerging among E. coli causing community acquired urinary tract infections (COMA-UTI).

OBJECTIVES:

To evaluate demographic and clinical risk factors associated with COMA-UTI due to quinolone-resistant E. coli (QREc).

METHODS:

In this case-control study, clinical and demographic data from 300 COMA-UTI due to E. coli (including 150 QREc) were analyzed.

RESULTS:

By univariate analysis QREc was associated to males, older patients, nursing home residents, functionally dependent, dementia, diabetes, cardiovascular diseases, immunosupression, nephrolithiasis, recurrent UTI, invasive procedures, hospitalization, and antibiotic use within previous 6 months. By multivariate analysis, use of ciprofloxacin (OR 20.6 [CI 2.3-179.2], p=0.006) or ofloxacin (OR 7.5 [CI 2.9-19.4], p<0.0001), previous invasive procedure (OR 6.6 [CI 3.0-14.7], p<0.0001), recurrent UTI (OR 4.7 [CI 2.3-9.3], p<0.0001), and previous hospitalization (OR 2.9 [CI 1.4-6], p=0.003) were identified as independent risk factors for COMA-UTI due to QREc.

CONCLUSION:

In patients with one or more of the risk factors identified here, the empiric use of quinolones should be reconsidered.

PMID:
18193386
DOI:
10.1007/s15010-007-7083-y
[Indexed for MEDLINE]
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