Factors Associated with Acute Community-Acquired Pyelonephritis Caused by Extended-Spectrum β-Lactamase-Producing <i>Escherichia coli</i>
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 <i>Escherechia coli</i> (<i>E. coli)</i>, with a view of optimising empirical antibiotic ther...
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| Autores principales: | , , , , , |
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| Formato: | article |
| Lenguaje: | EN |
| Publicado: |
MDPI AG
2021
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| Materias: | |
| Acceso en línea: | https://doaj.org/article/77eda5b7aeb94eec8205d2a2f2a68608 |
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| Sumario: | 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 <i>Escherechia coli</i> (<i>E. coli)</i>, with a view of optimising empirical antibiotic therapy in this context. We performed a retrospective analysis of patients with community-acquired APN and confirmed <i>E. coli</i> 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 <i>E. coli</i> 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 <i>E. coli</i> infection in 80.2% of cases. |
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