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Temporal trends and risk factors for extended-spectrum beta-lactamase-producing Escherichia coli in adults with catheter-associated urinary tract infections.

Spadafino JT, Cohen B, Liu J, Larson E - Antimicrob Resist Infect Control (2014)

Bottom Line: A case-control design was used to determine factors associated with having a CAUTI caused by an ESBL-producing E. coli versus a non-ESBL-producing E. coli.Prior antibiotic treatment and urinary tract disease significantly increased odds of ESBL.This study provides evidence that treatment with beta-lactam and non-beta-lactam antibiotics is a risk factor for acquiring ESBL-producing E. coli CAUTI, and the prevalence of this organism may be increasing in acute care hospitals.

View Article: PubMed Central - PubMed

Affiliation: Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th Street, New York, NY 10032 USA.

ABSTRACT

Background: Extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli cause up to 10% of catheter-associated urinary tract infections (CAUTI). We report changes in ESBL prevalence among CAUTIs in an adult acute care hospital from 2006-2012 and describe factors associated ESBL-production among E. coli CAUTI.

Findings: Data on patients ≥18 years discharged from a 647-bed tertiary/quaternary care hospital (2006-2012), a 221-bed community hospital (2007-2012), and a 914-bed tertiary/quaternary care hospital (2008) were obtained retrospectively from an electronic database (N = 415,430 discharges). Infections were identified using a previously validated electronic algorithm. Information on medical conditions and treatments were collected from electronic health records and discharge billing codes. A case-control design was used to determine factors associated with having a CAUTI caused by an ESBL-producing E. coli versus a non-ESBL-producing E. coli. Changes in yearly proportion of ESBL E. coli CAUTI at the 647-bed tertiary/quaternary care hospital were evaluated. ESBL increased from 4% in 2006 to 14% in 2012, peaking at 18% in 2009. Prior antibiotic treatment and urinary tract disease significantly increased odds of ESBL.

Conclusions: This study provides evidence that treatment with beta-lactam and non-beta-lactam antibiotics is a risk factor for acquiring ESBL-producing E. coli CAUTI, and the prevalence of this organism may be increasing in acute care hospitals.

No MeSH data available.


Related in: MedlinePlus

Percentage by year ofEscherichia coliCAUTI which were ESBL-positive in an adult tertiary/quaternary care hospital,2006-2012. Yearly change in proportion is significant using Cochran-Armitage test for trend (p < 0.0001).
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Fig1: Percentage by year ofEscherichia coliCAUTI which were ESBL-positive in an adult tertiary/quaternary care hospital,2006-2012. Yearly change in proportion is significant using Cochran-Armitage test for trend (p < 0.0001).

Mentions: During the seven-year study period a total of 2,164 patients (1,616 women, 74.7%, and 548 men, 25.3%) developed a CAUTI with E. coli as the primary infecting pathogen, and 271 (12.5%) were ESBL-producing. The proportion of E. coli CAUTI that were ESBL-producers in the 647-bed tertiary/quaternary care hospital increased from 4% in 2006 to 14% in 2012, peaking at 18% in 2009 (p < 0.0001; Figure 1). Over half of patients with CAUTI were diagnosed within 4 days of catheter insertion, over three-quarters within 8 days, and over 98% (n = 2,123) within 30 days. Descriptive characteristics and antibiotics administered prior to CAUTI onset are summarized for cases and controls in Table 1.Figure 1


Temporal trends and risk factors for extended-spectrum beta-lactamase-producing Escherichia coli in adults with catheter-associated urinary tract infections.

Spadafino JT, Cohen B, Liu J, Larson E - Antimicrob Resist Infect Control (2014)

Percentage by year ofEscherichia coliCAUTI which were ESBL-positive in an adult tertiary/quaternary care hospital,2006-2012. Yearly change in proportion is significant using Cochran-Armitage test for trend (p < 0.0001).
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4306238&req=5

Fig1: Percentage by year ofEscherichia coliCAUTI which were ESBL-positive in an adult tertiary/quaternary care hospital,2006-2012. Yearly change in proportion is significant using Cochran-Armitage test for trend (p < 0.0001).
Mentions: During the seven-year study period a total of 2,164 patients (1,616 women, 74.7%, and 548 men, 25.3%) developed a CAUTI with E. coli as the primary infecting pathogen, and 271 (12.5%) were ESBL-producing. The proportion of E. coli CAUTI that were ESBL-producers in the 647-bed tertiary/quaternary care hospital increased from 4% in 2006 to 14% in 2012, peaking at 18% in 2009 (p < 0.0001; Figure 1). Over half of patients with CAUTI were diagnosed within 4 days of catheter insertion, over three-quarters within 8 days, and over 98% (n = 2,123) within 30 days. Descriptive characteristics and antibiotics administered prior to CAUTI onset are summarized for cases and controls in Table 1.Figure 1

Bottom Line: A case-control design was used to determine factors associated with having a CAUTI caused by an ESBL-producing E. coli versus a non-ESBL-producing E. coli.Prior antibiotic treatment and urinary tract disease significantly increased odds of ESBL.This study provides evidence that treatment with beta-lactam and non-beta-lactam antibiotics is a risk factor for acquiring ESBL-producing E. coli CAUTI, and the prevalence of this organism may be increasing in acute care hospitals.

View Article: PubMed Central - PubMed

Affiliation: Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th Street, New York, NY 10032 USA.

ABSTRACT

Background: Extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli cause up to 10% of catheter-associated urinary tract infections (CAUTI). We report changes in ESBL prevalence among CAUTIs in an adult acute care hospital from 2006-2012 and describe factors associated ESBL-production among E. coli CAUTI.

Findings: Data on patients ≥18 years discharged from a 647-bed tertiary/quaternary care hospital (2006-2012), a 221-bed community hospital (2007-2012), and a 914-bed tertiary/quaternary care hospital (2008) were obtained retrospectively from an electronic database (N = 415,430 discharges). Infections were identified using a previously validated electronic algorithm. Information on medical conditions and treatments were collected from electronic health records and discharge billing codes. A case-control design was used to determine factors associated with having a CAUTI caused by an ESBL-producing E. coli versus a non-ESBL-producing E. coli. Changes in yearly proportion of ESBL E. coli CAUTI at the 647-bed tertiary/quaternary care hospital were evaluated. ESBL increased from 4% in 2006 to 14% in 2012, peaking at 18% in 2009. Prior antibiotic treatment and urinary tract disease significantly increased odds of ESBL.

Conclusions: This study provides evidence that treatment with beta-lactam and non-beta-lactam antibiotics is a risk factor for acquiring ESBL-producing E. coli CAUTI, and the prevalence of this organism may be increasing in acute care hospitals.

No MeSH data available.


Related in: MedlinePlus