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 ther...

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Autores principales:	Mónica Romero Nieto, Sara Maestre Verdú, Vicente Gil, Carlos Pérez Barba, Jose Antonio Quesada Rico, Reyes Pascual Pérez
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	acute pyelonephritis <i>Escherichia coli</i> extended-spectrum ß-lactamase Medicine R
Acceso en línea:	https://doaj.org/article/77eda5b7aeb94eec8205d2a2f2a68608
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spelling	oai:doaj.org-article:77eda5b7aeb94eec8205d2a2f2a686082021-11-11T17:47:51ZFactors Associated with Acute Community-Acquired Pyelonephritis Caused by Extended-Spectrum β-Lactamase-Producing <i>Escherichia coli</i>10.3390/jcm102151922077-0383https://doaj.org/article/77eda5b7aeb94eec8205d2a2f2a686082021-11-01T00:00:00Zhttps://www.mdpi.com/2077-0383/10/21/5192https://doaj.org/toc/2077-0383This 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.Mónica Romero NietoSara Maestre VerdúVicente GilCarlos Pérez BarbaJose Antonio Quesada RicoReyes Pascual PérezMDPI AGarticleacute pyelonephritis<i>Escherichia coli</i>extended-spectrum ß-lactamaseMedicineRENJournal of Clinical Medicine, Vol 10, Iss 5192, p 5192 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	acute pyelonephritis <i>Escherichia coli</i> extended-spectrum ß-lactamase Medicine R
spellingShingle	acute pyelonephritis <i>Escherichia coli</i> extended-spectrum ß-lactamase Medicine R Mónica Romero Nieto Sara Maestre Verdú Vicente Gil Carlos Pérez Barba Jose Antonio Quesada Rico Reyes Pascual Pérez Factors Associated with Acute Community-Acquired Pyelonephritis Caused by Extended-Spectrum β-Lactamase-Producing <i>Escherichia coli</i>
description	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.
format	article
author	Mónica Romero Nieto Sara Maestre Verdú Vicente Gil Carlos Pérez Barba Jose Antonio Quesada Rico Reyes Pascual Pérez
author_facet	Mónica Romero Nieto Sara Maestre Verdú Vicente Gil Carlos Pérez Barba Jose Antonio Quesada Rico Reyes Pascual Pérez
author_sort	Mónica Romero Nieto
title	Factors Associated with Acute Community-Acquired Pyelonephritis Caused by Extended-Spectrum β-Lactamase-Producing <i>Escherichia coli</i>
title_short	Factors Associated with Acute Community-Acquired Pyelonephritis Caused by Extended-Spectrum β-Lactamase-Producing <i>Escherichia coli</i>
title_full	Factors Associated with Acute Community-Acquired Pyelonephritis Caused by Extended-Spectrum β-Lactamase-Producing <i>Escherichia coli</i>
title_fullStr	Factors Associated with Acute Community-Acquired Pyelonephritis Caused by Extended-Spectrum β-Lactamase-Producing <i>Escherichia coli</i>
title_full_unstemmed	Factors Associated with Acute Community-Acquired Pyelonephritis Caused by Extended-Spectrum β-Lactamase-Producing <i>Escherichia coli</i>
title_sort	factors associated with acute community-acquired pyelonephritis caused by extended-spectrum β-lactamase-producing <i>escherichia coli</i>
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/77eda5b7aeb94eec8205d2a2f2a68608
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Factors Associated with Acute Community-Acquired Pyelonephritis Caused by Extended-Spectrum β-Lactamase-Producing <i>Escherichia coli</i>

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