Factores predictores de infección urinaria bacteriémica por Escherichia coli productor de betalactamasas de espectro extendido / Risk factors for extended espectrum beta- lactamase producer E. coli bacteremia from urinary origin

Fundamento y objectivos: Pocos trabajos han valorado el riesgo específico de infección urinaria bacteriémica por Escherichia coli productor de betalactamasas de espectro extendido (BLEE). Pacientes y métodos: Serie de casos retrospectiva de todos los pacientes con infección urinaria bacteriémica por E. coli atendidos en nuestro centro durante el 2006. Resultados: Se aisló BLEE en 19 casos (17,9%) de 106 bacteriemias de foco urinario. Los pacientes con bacteriemia por BLEE eran predominantemente varones, de mayor edad, procedentes de residencia de ancianos, con enfermedad urológica previa y manipulación urológica más frecuente, con mayor uso de antibiótico previo, con porcentaje más alto de infecciones urinarias previas, mayor frecuencia de infección nosocomial e ingreso en el mes previo. En la regresión logística, resultaron variables independientes predictoras de infección urinaria bacteriémica por BLEE la enfermedad urológica previa (odds ratio [OR]: 13,9, intervalo de confianza [IC] del 95%: 2,5–8,2) y estar institucionalizado en residencia (OR: 6,5, IC del 95%: 1,4–30,9) Conclusiones: La enfermedad urológica previa y estar institucionalizado en residencia son factores de riesgo independientes para presentar infección urinaria bacteriémica por BLEE (AU)

Background and objective: Although risk factors for extended spectrum beta lactamase E. coli (EBLE) infection have been explored, specific risk factors for bacteremic urinary tract infection by EBLE have been hardly analyzed. Patients and methos: We collected data from all patients with bacteremic urinary tract infection by E. coli attended in our hospital during 2006. Logistic regression was performed to explore predictors for EBLE bloodstream infection in this group of patients. Results: EBLE was present in 19 cases (17,9%) out of 106 bacteraemia from urinary origin. Patients with bloodstream infection by EBLE were male, older, demented, living in a nursing home, with previous urologic diseases and urologic manipulation, with a higher percentage of previous urinary tract infection, previous antibiotic use, more frequent nosocomial infection, and hospital admission in the previous month. In the logistic regression analysis, only previous urologic diseases (OR 13,9; IC95% 2,5–78,2) and living in a nursing home (OR 6,5; IC95% 1,4–0,9) were associated with EBLE bacteremic urinary tract infection. Conclusions: Previous urologic disease and living in a nursing home are independent risk factors for EBLE bacteremic urinary tract infection (AU)

[Risk factors for extended espectrum beta-lactamase producer E.coli bacteremia from urinary origin]. / Factores predictores de infección urinaria bacteriémica por Escherichia coli productor de betalactamasas de espectro extendido.

BACKGROUND AND OBJECTIVE: Although risk factors for extended spectrum beta lactamase E. coli (EBLE) infection have been explored, specific risk factors for bacteremic urinary tract infection by EBLE have been hardly analyzed. PATIENTS AND METHODS: We collected data from all patients with bacteremic urinary tract infection by E. coli attended in our hospital during 2006. Logistic regression was performed to explore predictors for EBLE bloodstream infection in this group of patients. RESULTS: EBLE was present in 19 cases (17,9%) out of 106 bacteraemia from urinary origin. Patients with bloodstream infection by EBLE were male, older, demented, living in a nursing home, with previous urologic diseases and urologic manipulation, with a higher percentage of previous urinary tract infection, previous antibiotic use, more frequent nosocomial infection, and hospital admission in the previous month. In the logistic regression analysis, only previous urologic diseases (OR 13,9; IC95% 2,5-78,2) and living in a nursing home (OR 6,5; IC95% 1,4-0,9) were associated with EBLE bacteremic urinary tract infection. CONCLUSIONS: Previous urologic disease and living in a nursing home are independent risk factors for EBLE bacteremic urinary tract infection.