Prospective cohort study of risk factors for extended-spectrum ß-lactamase-producing Escherichia coli urinary tract infections in elderly patients admitted to hospital

Abstract

SummaryBackground: Extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli are

Variation of effect estimates in the analysis of mortality and length of hospital stay in patients with infections caused by bacteria-producing extended-spectrum beta-lactamases: a systematic review and meta-analysis

“…Full-text screening excluded an additional 5 articles, providing an evidence base of 87 studies (figure 1). 10–96 The 87 studies included in the qualitative analysis were conducted between 1991 and 2017 in 25 countries, mainly in South Korea (14 studies), Thailand (7), USA (7), Taiwan (7) and Spain (7). Sixty (68.9%) studies were performed in HICs, 26 (29.9%) in LMICs and 1 included both HICs and LMICs 56.…”

Influence of primary care antibiotic prescribing on incidence rates of multidrug-resistant Gram-negative bacteria in hospitalised patients

“…The following non-antibiotic host-related risk factors were determined as independent predictors of MRGN detection in hospital: the presence of genitourinary underlying disease (as a primary diagnosis), being female, being elderly and having an extended in-hospital stay. When a host's immune system is suppressed, accompanied by the occurrence of neutropenia due, for example, to the administration of chemotherapy, being elderly, being a neonate or having immune deficiency syndrome, the vulnerability of the host to acquire resistant bacterial strains is enhanced [10,[33][34][35]. In the present study, female patients were shown to be significantly more likely to be in the case group than in the randomly selected control group.…”

“…In the present study, there was a firm linkage between having an extended hospitalisation period and the recovery rate of MRGN in hospital. Several previous studies have also reported this latter relationship [8,10]. The methodology used was unable to differentiate whether the longer stay was due to the MRGN isolation or whether the MRGN detection was directly linked to length of stay.…”

“…High antibiotic consumption is a well-established risk factor associated with the acquisition of Clostridium difficile infection (CDI), meticillin-resistant Staphylococcus aureus (MRSA) and MRGN bacteria [5,6]. Many studies have demonstrated that infection with MRGN bacteria is associated with an increased rate of morbidity and mortality together with other measures of clinical failure including: longer hospital stay and/or increased antibiotic consumption within the hospital and community settings [2][3][4][5][6][7][8][9][10][11]. Since the late 1990s, multidrug-resistant CTX-M-producing Escherichia coli have been detected within the primary healthcare setting as a leading cause of urinary tract infections and community-onset bacteraemia [7,[12][13][14] .…”

Diagnosis of urinary tract infection in older persons in the emergency department: To pee or not to pee, that is the question

“…Antibiotic resistance in E. coli is a significant problem. The prevalence of extended spectrum beta‐lactamase‐producing E. coli is growing, most particularly in hospital‐acquired UTI, where prevalence is up to 44% . Extended‐spectrum cephalosporin‐resistant E. coli prevalence in Australia and New Zealand is reported at 3% …”