(HealthDay News) — Community-onset urinary tract infection (UTI) due to extended-spectrum cephalosporin-resistant (ESC-R) Enterobacteriaceae (EB) is significantly associated with clinical failure, according to a study published online Oct. 30 in Infection Control & Hospital Epidemiology.
Judith A. Anesi, MD, from the University of Pennsylvania in Philadelphia, and colleagues conducted a retrospective cohort study involving patients presenting to emergency departments or outpatient practices with EB UTIs between 2010 and 2013. Exposed patients with ESC-R EB UTIs were matched to unexposed patients with EB UTIs based on study year (151 in each group).
In multivariable analyses, the researchers found that UTI due to an ESC-R EB was significantly associated with clinical failure (odds ratio, 7.07). Infection with Citrobacter spp and need for hemodialysis were also independent risk factors for clinical failure. There was also a significant association between UTI due to an ESC-R EB and inappropriate initial antibiotic therapy (odds ratio, 4.40).
“This study adds to the evidence that drug-resistant bacteria are an increasing issue, even in the community and even in patients who have something seemingly uncomplicated, like a urinary tract infection,” Anesi said in a statement. “These drug-resistant infections are difficult to treat, and our study shows that relapses are common. This is an alarming finding, and interventions to curb antibiotic resistance are urgently needed.”
Anesi JA, Lautenbach E, Nachamkin I, et al. Poor clinical outcomes associated with community-onset urinary tract infections due to extended-spectrum cephalosporin-resistant Enterobacteriaceae. Infection Contrl Hosp Epidemiol. DOI:10.1017/ice.2018.254