Treatment With Antibiotics is a Risk Factor for Acquiring ESBL-Producing E. coli CAUTI

Extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli cause up to 10 percent of catheter-associated urinary tract infections (CAUTI). Spadafino, et al. (2014) report changes in ESBL prevalence among CAUTIs in an adult acute care hospital from 2006-2012 and describe factors associated ESBL-production among E. coli CAUTI.

Data on patients discharged from a 647-bed tertiary/quaternary care hospital (2006-2012), a 221-bed community hospital (2007-2012), and a 914-bed tertiary/quaternary care hospital (2008) were obtained retrospectively from an electronic database. Infections were identified using a previously validated electronic algorithm. Information on medical conditions and treatments were collected from electronic health records and discharge billing codes. A case-control design was used to determine factors associated with having a CAUTI caused by an ESBL-producing E. coli versus a non-ESBL-producing E. coli. Changes in yearly proportion of ESBL E. coli CAUTI at the 647-bed tertiary/quaternary care hospital were evaluated. ESBL increased from 4 percent in 2006 to 14 percent in 2012, peaking at 18 percent in 2009. Prior antibiotic treatment and urinary tract disease significantly increased odds of ESBL.

The researchers say this study provides evidence that treatment with beta-lactam and non-beta-lactam antibiotics is a risk factor for acquiring ESBL-producing E. coli CAUTI, and the prevalence of this organism may be increasing in acute care hospitals. Their research was published in Antimicrobial Resistance and Infection Control.

Reference: Spadafino JT, Cohen B, Liu J and Larson L. Temporal trends and risk factors for extended-spectrum beta-lactamase-producing Escherichia coli in adults with catheter-associated urinary tract infections. Antimicrobial Resistance and Infection Control 2014, 3:599  doi:10.1186/s13756-014-0039-y