Emerging extended-spectrum β-lactamase-producing Klebsiella pneumoniae causing community-onset urinary tract infections : a case-control-control study
Copyright © 2017 Elsevier B.V. and International Society of Chemotherapy. All rights reserved..
The aim of this study was to determine the epidemiology and risk factors associated with community-onset urinary tract infections (CO-UTIs) due to extended-spectrum β-lactamase-producing Klebsiella pneumoniae (ESBL-Kp). A cohort study including all consecutive patients with K. pneumoniae CO-UTI identified from January 2010 to December 2014 was conducted. Patients with CO-UTI due to ESBL-Kp were then included as cases in a retrospective case-control-control study; controls were outpatients with CO-UTI caused by non-ESBL-producing Escherichia coli and K. pneumoniae (non-ESBL-Ec and non-ESBL-Kp, respectively). Each control was matched in a 2:1 ratio according to patient age, sex and year of isolation. Genotyping confirming ESBL was performed by multiplex PCR and sequencing. The prevalence of ESBL-Kp CO-UTIs, calculated among all K. pneumoniae CO-UTIs, increased from 2.4% in 2010 to 10.3% in 2014 (P = 0.01). Among cases, 63.8% were truly community-acquired, and CTX-M-15 was the predominant β-lactamase enzyme type (79.3%). A total of 83 cases and 319 controls were studied. Being a nursing home resident [odds ratio (OR) = 8.8, 95% confidence interval (CI) 2.6-29.4] and previous cephalosporin use (OR = 4.01, 95% CI 1.8-9.2) were risk factors independently associated with CO-UTI due to ESBL-Kp. In conclusion, the prevalence of CO-UTIs due to ESBL-Kp is increasing. In most cases, ESBL-Kp CO-UTIs are community-acquired and produce CTX-M-15 β-lactamase. Exposure to cephalosporins and being a nursing home resident were risk factors associated with ESBL-Kp CO-UTIs. CTX-M-15-producing K. pneumoniae isolates are emerging in the community.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2017 |
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| Erschienen: |
2017 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:50 |
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| Enthalten in: |
International journal of antimicrobial agents - 50(2017), 2 vom: 01. Aug., Seite 197-202 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Boix-Palop, Lucía [VerfasserIn] |
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| Links: |
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| Themen: |
Beta-Lactamases |
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| Anmerkungen: |
Date Completed 01.05.2018 Date Revised 30.03.2022 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.ijantimicag.2017.03.009 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM27233488X |
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| 245 | 1 | 0 | |a Emerging extended-spectrum β-lactamase-producing Klebsiella pneumoniae causing community-onset urinary tract infections |b a case-control-control study |
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| 520 | |a Copyright © 2017 Elsevier B.V. and International Society of Chemotherapy. All rights reserved. | ||
| 520 | |a The aim of this study was to determine the epidemiology and risk factors associated with community-onset urinary tract infections (CO-UTIs) due to extended-spectrum β-lactamase-producing Klebsiella pneumoniae (ESBL-Kp). A cohort study including all consecutive patients with K. pneumoniae CO-UTI identified from January 2010 to December 2014 was conducted. Patients with CO-UTI due to ESBL-Kp were then included as cases in a retrospective case-control-control study; controls were outpatients with CO-UTI caused by non-ESBL-producing Escherichia coli and K. pneumoniae (non-ESBL-Ec and non-ESBL-Kp, respectively). Each control was matched in a 2:1 ratio according to patient age, sex and year of isolation. Genotyping confirming ESBL was performed by multiplex PCR and sequencing. The prevalence of ESBL-Kp CO-UTIs, calculated among all K. pneumoniae CO-UTIs, increased from 2.4% in 2010 to 10.3% in 2014 (P = 0.01). Among cases, 63.8% were truly community-acquired, and CTX-M-15 was the predominant β-lactamase enzyme type (79.3%). A total of 83 cases and 319 controls were studied. Being a nursing home resident [odds ratio (OR) = 8.8, 95% confidence interval (CI) 2.6-29.4] and previous cephalosporin use (OR = 4.01, 95% CI 1.8-9.2) were risk factors independently associated with CO-UTI due to ESBL-Kp. In conclusion, the prevalence of CO-UTIs due to ESBL-Kp is increasing. In most cases, ESBL-Kp CO-UTIs are community-acquired and produce CTX-M-15 β-lactamase. Exposure to cephalosporins and being a nursing home resident were risk factors associated with ESBL-Kp CO-UTIs. CTX-M-15-producing K. pneumoniae isolates are emerging in the community | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a CTX-M-15 | |
| 650 | 4 | |a Community-onset | |
| 650 | 4 | |a Extended-spectrum β-lactamase | |
| 650 | 4 | |a Klebsiella pneumoniae | |
| 650 | 4 | |a Urinary tract infection | |
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| 700 | 1 | |a Xercavins, Mariona |e verfasserin |4 aut | |
| 700 | 1 | |a Badía, Cristina |e verfasserin |4 aut | |
| 700 | 1 | |a Obradors, Meritxell |e verfasserin |4 aut | |
| 700 | 1 | |a Riera, Montserrat |e verfasserin |4 aut | |
| 700 | 1 | |a Freixas, Núria |e verfasserin |4 aut | |
| 700 | 1 | |a Pérez, Josefa |e verfasserin |4 aut | |
| 700 | 1 | |a Rodríguez-Carballeira, Mónica |e verfasserin |4 aut | |
| 700 | 1 | |a Garau, Javier |e verfasserin |4 aut | |
| 700 | 1 | |a Calbo, Esther |e verfasserin |4 aut | |
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