Factors associated with the recurrence of acute pyelonephritis caused by extended-spectrum β-lactamase-producing Escherichia coli: the importance of infectious disease consultation

Diagn Microbiol Infect Dis. 2019 May;94(1):55-59. doi: 10.1016/j.diagmicrobio.2018.11.019. Epub 2018 Nov 29.

Abstract

To investigate factors for the recurrence of acute pyelonephritis (APN) caused by extended-spectrum β-lactamase-producing Escherichia coli (ESBL-PE), a retrospective cohort study was performed at a tertiary-care hospital from 2014 through 2016. Among 135 patients who had recovered from APN caused by ESBL-PE, the 1-year cumulative recurrence rates of APN caused by any pathogen or by ESBL-PE specifically were 35.6% and 22.1%, respectively. In a multivariate analysis, infectious disease (ID) consultation was associated with decreased recurrence (95% confidence interval [CI] = 0.24-0.96, P = 0.038 for recurrence caused by any pathogen; and 95% CI = 0.15-0.84, P = 0.019 for recurrence caused by ESBL-PE). History of APN within 1 year was a risk factor for recurrent APN caused by any pathogen (P = 0.011). Microbiological cure was a preventive factor for recurrent APN caused by ESBL-PE (P = 0.024). In conclusion, our data show that ID consultation protects against APN recurrence caused by ESBL-PE.

Keywords: Acute pyelonephritis; Extended-spectrum β-lactamase; Recurrence.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Delivery of Health Care / methods*
  • Escherichia coli / enzymology*
  • Escherichia coli / isolation & purification
  • Escherichia coli Infections / epidemiology*
  • Escherichia coli Infections / microbiology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pyelonephritis / epidemiology*
  • Pyelonephritis / microbiology
  • Recurrence
  • Referral and Consultation*
  • Retrospective Studies
  • Risk Factors
  • Tertiary Care Centers
  • Young Adult
  • beta-Lactamases / metabolism*

Substances

  • beta-Lactamases