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Risk Factors for Community-Acquired Urinary Tract Infection Due to Quinolone-Resistant E. coli.

Colodner R, Kometiani I, Chazan B, Raz R

Clinical Microbiology Laboratory, Ha'Emek Medical Center, 18101, Afula, Israel, colodner_ra@clalit.org.il.

BACKGROUND: Resistance to fluoroquinolone drugs is emerging among E. coli causing community acquired urinary tract infections (COMA-UTI). OBJECTIVES: To evaluate demographic and clinical risk factors associated with COMA-UTI due to quinolone-resistant E. coli (QREc). METHODS: In this case-control study, clinical and demographic data from 300 COMA-UTI due to E. coli (including 150 QREc) were analyzed. RESULTS: By univariate analysis QREc was associated to males, older patients, nursing home residents, functionally dependent, dementia, diabetes, cardiovascular diseases, immunosupression, nephrolithiasis, recurrent UTI, invasive procedures, hospitalization, and antibiotic use within previous 6 months. By multivariate analysis, use of ciprofloxacin (OR 20.6 [CI 2.3-179.2], p = 0.006) or ofloxacin (OR 7.5 [CI 2.9-19.4], p < 0.0001), previous invasive procedure (OR 6.6 [CI 3.0-14.7], p < 0.0001), recurrent UTI (OR 4.7 [CI 2.3-9.3], p < 0.0001), and previous hospitalization (OR 2.9 [CI 1.4-6], p = 0.003) were identified as independent risk factors for COMA-UTI due to QREc. CONCLUSION: In patients with one or more of the risk factors identified here, the empiric use of quinolones should be reconsidered.

Published 15 February 2008 in Infection, 36(1): 41-5.
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