Epidemiology of urinary tract infection in adults caused by extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae - a case-control study from Qatar

Vamanjore A Naushad; Nishan K Purayil; Godwin J Wilson; Prem Chandra; Prakash Joseph; Zahida Khalil; Muhammad Zahid; Muhammed K Kayakkool; NoorJahan Shaik; Basma Ayari; Sajid Chalihadan; Emad Basheir I Elmagboul; Sanjay H Doiphode

doi:10.1016/j.ijregi.2022.05.001

Epidemiology of urinary tract infection in adults caused by extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae - a case-control study from Qatar

IJID Reg. 2022 May 4:3:278-286. doi: 10.1016/j.ijregi.2022.05.001. eCollection 2022 Jun.

Authors

Vamanjore A Naushad^{1

2

3}, Nishan K Purayil^{1

2

3}, Godwin J Wilson^{4

3}, Prem Chandra⁵, Prakash Joseph^{1

2}, Zahida Khalil^{1

2}, Muhammad Zahid^{1

3}, Muhammed K Kayakkool^{1

2

3}, NoorJahan Shaik¹, Basma Ayari^{1

3}, Sajid Chalihadan¹, Emad Basheir I Elmagboul⁴, Sanjay H Doiphode^{4

3}

Affiliations

¹ General Internal Medicine Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.
² College of Medicine, Qatar University, Doha, Qatar.
³ Weill Cornell Medicine, Qatar.
⁴ Department Of Microbiology, Hamad Medical Corporation, Doha, Qatar.
⁵ Medical Research Centre, Hamad Medical Corporation, Doha, Qatar.

Abstract

Background: Community-acquired urinary tract infection (UTI) is the most common infection caused by extended-spectrum beta-lactamase (ESBL)-producing organisms.

Aim: to estimate the prevalence of ESBL-UTI in adults and to identify potential risk factors that may predispose to ESBL-UTI.

Methods: A retrospective study involving adult patients with UTI caused by ESBL-producing organisms was undertaken. Patients with UTI caused by non-ESBL-producing organisms represented the control group.

Results: In total, 1100 UTI isolates were included in the study, 277 of which were ESBL positive. The prevalence rate was 25.2%. The mean age of patients was 55.87 years. On univariate analysis, prior history of UTI or ESBL-UTI, invasive urological procedure within preceding 3 months, hospital admission within preceding 3 months, and exposure to antibiotics were found to be significant risk factors for ESBL-UTI. On multi-variate analysis, use of cephalosporins [adjusted odds ratio (OR) 1.61, P=0.048], previous ESBL-UTI (adjusted OR 2.67, P<0.001), and invasive urological procedure in the preceding year (adjusted OR 1.61, P=0.022) were found to be independent risk factors for ESBL-UTI.

Conclusions: In Qatar, the prevalence of ESBL-UTI in adults is modest. Recent exposure to antibiotics, previous ESBL-UTI and invasive urological procedures were found to be independent risk factors for ESBL-UTI.

Keywords: Antibiotics; ESBL; Extended-spectrum beta-lactamase; Urinary tract infections.