Extended-spectrum β-lactamase- and AmpC β-lactamase-producing Enterobacterales associated with urinary tract infections in the New Zealand community: a case-control study

Leah J Toombs-Ruane; Jonathan C Marshall; Jackie Benschop; Dragana Drinković; Anne C Midwinter; Patrick J Biggs; Zoë Grange; Michael G Baker; Jeroen Douwes; Mick G Roberts; Nigel P French; Sara A Burgess

doi:10.1016/j.ijid.2022.12.013

Extended-spectrum β-lactamase- and AmpC β-lactamase-producing Enterobacterales associated with urinary tract infections in the New Zealand community: a case-control study

Int J Infect Dis. 2023 Mar:128:325-334. doi: 10.1016/j.ijid.2022.12.013. Epub 2022 Dec 16.

Authors

Affiliations

¹ (m)EpiLab, School of Veterinary Science, Massey University, Palmerston North, New Zealand.
² (m)EpiLab, School of Veterinary Science, Massey University, Palmerston North, New Zealand; School of Mathematical and Computational Sciences, Massey University, Palmerston North, New Zealand.
³ Microbiology Department, North Shore Hospital, Auckland, New Zealand.
⁴ (m)EpiLab, School of Veterinary Science, Massey University, Palmerston North, New Zealand; School of Natural Sciences, Massey University, Palmerston North, New Zealand; New Zealand Food Safety Science and Research Centre, Massey University, Palmerston North, New Zealand.
⁵ Department of Public Health, University of Otago, Wellington, New Zealand.
⁶ Research Centre for Hauora and Health, Massey University, Wellington, New Zealand.
⁷ New Zealand Institute for Advanced Study, Massey University, Auckland, New Zealand.
⁸ (m)EpiLab, School of Veterinary Science, Massey University, Palmerston North, New Zealand; New Zealand Food Safety Science and Research Centre, Massey University, Palmerston North, New Zealand; Research Centre for Hauora and Health, Massey University, Wellington, New Zealand.
⁹ (m)EpiLab, School of Veterinary Science, Massey University, Palmerston North, New Zealand. Electronic address: s.burgess1@massey.ac.nz.

PMID: 36529370
DOI: 10.1016/j.ijid.2022.12.013

Abstract

Objectives: To assess whether having a pet in the home is a risk factor for community-acquired urinary tract infections associated with extended-spectrum β-lactamase (ESBL)- or AmpC β-lactamase (ACBL)- producing Enterobacterales.

Methods: An unmatched case-control study was conducted between August 2015 and September 2017. Cases (n = 141) were people with community-acquired urinary tract infection (UTI) caused by ESBL- or ACBL-producing Enterobacterales. Controls (n = 525) were recruited from the community. A telephone questionnaire on pet ownership and other factors was administered, and associations were assessed using logistic regression.

Results: Pet ownership was not associated with ESBL- or ACBL-producing Enterobacterales-related human UTIs. A positive association was observed for recent antimicrobial treatment, travel to Asia in the previous year, and a doctor's visit in the last 6 months. Among isolates with an ESBL-/ACBL-producing phenotype, 126/134 (94%) were Escherichia coli, with sequence type 131 being the most common (47/126).

Conclusions: Companion animals in the home were not found to be associated with ESBL- or ACBL-producing Enterobacterales-related community-acquired UTIs in New Zealand. Risk factors included overseas travel, recent antibiotic use, and doctor visits.

Keywords: AmpC; Antimicrobial resistance; E. coli; ESBL; Enterobacterales; Urinary tract infection.

MeSH terms

Animals
Anti-Bacterial Agents / therapeutic use
Case-Control Studies
Community-Acquired Infections* / epidemiology
Community-Acquired Infections* / microbiology
Escherichia coli
Escherichia coli Infections* / epidemiology
Humans
New Zealand
Risk Factors
Urinary Tract Infections* / epidemiology
Urinary Tract Infections* / microbiology
beta-Lactamases / genetics

Substances

AmpC beta-lactamases
Anti-Bacterial Agents
beta-Lactamases