Infection and Drug Resistance (Nov 2020)

Risk Factors of Extended-Spectrum Beta-Lactamases-Producing Escherichia coli Community Acquired Urinary Tract Infections: A Systematic Review

  • Larramendy S,
  • Deglaire V,
  • Dusollier P,
  • Fournier JP,
  • Caillon J,
  • Beaudeau F,
  • Moret L

Journal volume & issue
Vol. Volume 13
pp. 3945 – 3955

Abstract

Read online

Stéphanie Larramendy,1 Valentine Deglaire,1 Paul Dusollier,1 Jean-Pascal Fournier,1 Jocelyne Caillon,2 François Beaudeau,3 Leïla Moret4,5 1Department of General Practice, Faculty of Medicine, University of Nantes, Nantes 44000, France; 2IRS 2 Laboratoire de Thérapeutique Expérimentale et Clinique des Infections, EA3826, University of Nantes, Nantes 44400, France; 3BIOEPAR, INRA, Oniris, Nantes 44307, France; 4Public Health Department, CHU Nantes, Saint-Jacques Hospital, Nantes 44093, France; 5UMR 1246 INSERM SPHERE “MethodS in Patients-Centered Outcomes and HEalth ResEarch”, University of Nantes and Tours, Nantes 44200, FranceCorrespondence: Stéphanie LarramendyDépartement de Médecine Générale, Faculté de Médecine, Université de Nantes, Nantes, FranceTel + 33 (0) 24 041 1129Fax + 33 (0) 24 041 2879Email [email protected]: The prevalence of extended-spectrum beta-lactamase-producing Escherichia coli (ESBL-EC) has been increasing worldwide since the early 2000s. E. coli is found in 70– 90% of community-acquired urinary tract infections (CA-UTIs). We performed a systematic literature review to determine the risk factors for CA-UTI caused by ESBL-EC.Methods: We searched the MEDLINE, Cochrane Library, Embase and Web of Science databases without language or date restriction up to March 2019. Two independent reviewers selected studies with quantified risk factors for CA-UTI due to ESBL-EC, and assessed their quality using the Newcastle-Ottawa Scale.Results: Among the 5,597 studies identified, 16 observational studies (n=12,138 patients) met the eligibility criteria. The included studies were performed in various countries, and 14/16 were published after 2012. The most relevant risk factors for CA-UTI due to ESBL-EC identified were prior use of antibiotics (odds ratio (OR) from 2.2 to 21.4), previous hospitalization (OR: 1.7 to 3.9), and UTI history (OR: 1.3 to 3.8). Two risk factors were related to environmental contamination: travelling abroad, and swimming in freshwater.Conclusion: Our findings could allow adapting empiric antibiotic treatments according to the patient profile. Further studies are needed to quantify the relationships between CA-UTI due to ESBL-EC and the environment.Keywords: multi-drug resistant bacteria, enterobacteria infection, community-acquired infection, risk factor, beta-lactam resistance, systematic review

Keywords