title: Epidemiological factors associated with ESBL- and non ESBL-producing E. coli causing urinary tract infection in general practice.
abstract: The purpose of the study was to evaluate how use of antibiotics precedes the presence of ESBL-producing E.coli in general practice. The authors performed a triple-case-control study where three case groups were individually compared to a single control group of uninfected individuals. Urine samples were prospectively collected and retrospective statistical analyses were done. This study included 98 cases with urinary tract infection (UTI) caused by ESBL-producing E. coli, 174 with antibiotic-resistant (non-ESBL) E. coli, 177 with susceptible E. coli and 200 with culture negative urine samples. Case groups had significantly higher use of antibiotics than the control group within 30 days before infection (p < 0.0001). The ESBL group had significantly more hospital admissions than the other case groups (p < 0.05). Hospital admission was an independent risk factor for community onset UTI by ESBL-producing E. coli. Exposure to antibiotics was a risk factor for UTI with E. coli, while prior antibiotic usage was not an indisputable predictor for infection with ESBL-producing E.coli in general practice.
authors.affiliation: a Department of Clinical Microbiology , Hvidovre University Hospital , Hvidovre , Denmark.|b Department of Biology , University of Copenhagen , Denmark.
authors.forename: Frederik Boëtius
authors.initials: FB
authors.lastname: Hertz
authors.affiliation: a Department of Clinical Microbiology , Hvidovre University Hospital , Hvidovre , Denmark.
authors.forename: Kristian
authors.initials: K
authors.lastname: Schønning
authors.affiliation: a Department of Clinical Microbiology , Hvidovre University Hospital , Hvidovre , Denmark.
authors.forename: Steen Christian
authors.initials: SC
authors.lastname: Rasmussen
authors.affiliation: a Department of Clinical Microbiology , Hvidovre University Hospital , Hvidovre , Denmark.
authors.forename: Pia
authors.initials: P
authors.lastname: Littauer
authors.affiliation: a Department of Clinical Microbiology , Hvidovre University Hospital , Hvidovre , Denmark.
authors.forename: Jenny Dahl
authors.initials: JD
authors.lastname: Knudsen
authors.affiliation: b Department of Biology , University of Copenhagen , Denmark.
authors.forename: Anders
authors.initials: A
authors.lastname: Løbner-Olesen
authors.affiliation: a Department of Clinical Microbiology , Hvidovre University Hospital , Hvidovre , Denmark.
authors.forename: Niels
authors.initials: N
authors.lastname: Frimodt-Møller
mesh_terms: D000328:Adult; D000561:Amdinocillin Pivoxil / Q000494:pharmacology / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use*; D016022:Case-Control Studies; D003718:Denmark / Q000453:epidemiology; D004926:Escherichia coli / Q000187:drug effects / Q000201:enzymology* / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D058006:General Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010343:Patient Admission; D010404:Penicillin V / Q000494:pharmacology / Q000627:therapeutic use; D012189:Retrospective Studies; D014552:Urinary Tract Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D018440:beta-Lactam Resistance; D001618:beta-Lactamases / Q000096:biosynthesis* / Q000235:genetics
chemical_list: D000900:Anti-Bacterial Agents; D000561:Amdinocillin Pivoxil; D001618:beta-Lactamases; D010404:Penicillin V
keywords: ESBL; Escherichia coli; UTI; community-acquired; risk factors