Risk factors for urinary tract infection caused by enterobacteriaceae with extended-spectrum beta-lactamase resistance in patients admitted to internal medicine departments

Moshe Vardi, Tamar Kochavi, Yaron Denekamp, Haim Bitterman

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Extended-spectrum beta-lactamase (ESBL) resistance is a growing concern in and outside hospitals. Physicians often face a true clinical dilemma when initiating empirical antibiotic treatment in patients admitted to internal medicine departments. Objectives: To determine the prevalence of risk factors for ESBL resistance in patients with urinary tract infection (UTI) admitted to internal medicine departments. Methods: We conducted a retrospective analysis of the medical records of patients with UTI admitted to an internal medicine division in a community-based academic hospital over a 1 year period. We collected clinical, laboratory and imaging data that were available to the treating physician at admission. Outcome measures included ESBL resistance and death. Results: Of the 6754 admissions 366 patients were included in the study. Hospitalization during the previous 3 months (odds ratio 3.4, P < 0.0001), residency in a long-term-care facility (OR 2.4, P = 0.004), and the presence of a permanent urinary catheter (OR 2.2, P = 0.015) were correlated to ESBL resistance with statistical significance. These risk factors were extremely prevalent in our patient cohort. Conclusions: ESBL resistance is becoming prevalent outside hospital settings, and patients admitted to an internal medicine department with UTI frequently carry risk factors for harboring resistant bacteria. In such patients a high index of suspicion and early targeted antibiotic treatment for ESBLproducing Enterobacteriaceae may be justified.

Original languageEnglish
Pages (from-to)115-118
Number of pages4
JournalIsrael Medical Association Journal
Volume14
Issue number2
StatePublished - Feb 2012
Externally publishedYes

Keywords

  • Outcomes
  • Prostate cancer
  • Prostate weight
  • Radical prostatectomy
  • Treatment

ASJC Scopus subject areas

  • General Medicine

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