title: Extended-Spectrum Beta-Lactamase-Producing Bacteria in a Urology Ward: Epidemiology, Risk Factors and Antimicrobial Susceptibility Patterns.
abstract: BACKGROUND
  Our aim was to describe the incidence and risk factors associated with extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae and their resistance rate in a urological ward.
  
  
  METHODS
  We carried out a prospective observational study from November 2011 to December 2014, reviewing healthcare-associated infections (HAIs) in our department. We evaluated the infections caused by ESBL-producing Enterobacteriaceae.
  
  
  RESULTS
  The incidence of HAIs in our urology ward was 6.8%. Enterobacteriaceae including Escherichia coli (24.9%), Klebsiella spp. (12.1%), Enterobacter spp. (5.9%), Morganella spp. (1.5%), Proteus spp. (1.5%), and Citrobacter spp. (1.5%) represented 47.4% of the isolated pathogens. The percentage of ESBL-producing Enterobacteriaceae was 26.4. Risk factors associated with a higher incidence of ESBL-producing bacteria were prior urinary tract infection (UTI; p < 0.001), hypertension (p = 0.042), immunosuppression (p = 0.004), and urinary stone (p = 0.027). The multivariable analysis confirmed prior UTI, immunosuppression and urinary stone as risk factors. ESBL-producing strains showed resistance rates of 85.3% for fluoroquinolones and 11.8% for carbapenems. Moreover, 16.7% of ESBL-Klebsiella were resistant to carbapenems.
  
  
  CONCLUSIONS
  ESBL-producing enterobacteria are associated with higher cross resistance to antibiotics such as quinolones. Higher resistance rates are reported in ESBL-producing Klebsiella. Among patients admitted in a urology ward, risk factors for ESBL-producing strains were previous UTI, immunosuppression, and urinary stone.
authors.affiliation: Department of Urology, Hospital Universitario 12 de Octubre, Madrid, Spain.
authors.forename: José
authors.initials: J
authors.lastname: Medina-Polo
authors.forename: Ana
authors.initials: A
authors.lastname: Arrébola-Pajares
authors.forename: Santiago
authors.initials: S
authors.lastname: Pérez-Cadavid
authors.forename: Raúl
authors.initials: R
authors.lastname: Benítez-Sala
authors.forename: Raquel
authors.initials: R
authors.lastname: Sopeña-Sutil
authors.forename: Alba
authors.initials: A
authors.lastname: Lara-Isla
authors.forename: Manuel
authors.initials: M
authors.lastname: Alsonso-Isa
authors.forename: Javier
authors.initials: J
authors.lastname: Gil-Moradillo
authors.forename: Juan
authors.initials: J
authors.lastname: Justo-Quintas
authors.forename: Natalia
authors.initials: N
authors.lastname: Miranda-Utrera
authors.forename: Luis
authors.initials: L
authors.lastname: Aguilar-Gisbert
authors.forename: Juan Bautista
authors.initials: JB
authors.lastname: Passas-Martínez
authors.forename: Ángel
authors.initials: Á
authors.lastname: Tejido-Sánchez
mesh_terms: D000368:Aged; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology*; D004755:Enterobacteriaceae / Q000187:drug effects / Q000201:enzymology; D004756:Enterobacteriaceae Infections / Q000453:epidemiology* / Q000382:microbiology*; D006748:Hospital Departments; D006801:Humans; D008826:Microbial Sensitivity Tests; D011446:Prospective Studies; D012307:Risk Factors; D014572:Urology; D001618:beta-Lactamases / Q000096:biosynthesis
chemical_list: D001618:beta-Lactamases