Factors Associated with Acute Community-Acquired Pyelonephritis Caused by Extended-Spectrum β-Lactamase-Producing Escherichia coli
| Autor: | Reyes Pascual Pérez, Vicente Gil, Carlos Pérez Barba, Mónica Romero Nieto, Sara Maestre Verdú, Jose Antonio Quesada Rico |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Multivariate analysis medicine.drug_class business.industry Urinary system Antibiotics Escherichia coli extended-spectrum ß-lactamase acute pyelonephritis Urinary incontinence Context (language use) General Medicine medicine.disease_cause medicine.disease Comorbidity Article Internal medicine medicine Medicine In patient medicine.symptom business |
| Zdroj: | Journal of Clinical Medicine Volume 10 Issue 21 Journal of Clinical Medicine, Vol 10, Iss 5192, p 5192 (2021) |
| ISSN: | 2077-0383 |
| DOI: | 10.3390/jcm10215192 |
| Popis: | This study aimed to identify the factors associated with the presence of extended-spectrum ß-lactamase-(ESBL) in patients with acute community-acquired pyelonephritis (APN) caused by Escherechia coli (E. coli), with a view of optimising empirical antibiotic therapy in this context. We performed a retrospective analysis of patients with community-acquired APN and confirmed E. coli infection, collecting data related to demographic characteristics, comorbidities, and treatment. The associations of these factors with the presence of ESBL were quantified by fitting multivariate logistic models. Goodness-of-fit and predictive performance were measured using the ROC curve. We included 367 patients of which 51 presented with ESBL, of whom 90.1% had uncomplicated APN, 56.1% were women aged ≤55 years, 33.5% had at least one mild comorbidity, and 12% had recently taken antibiotics. The prevalence of ESBL-producing E. coli was 13%. In the multivariate analysis, the factors independently associated with ESBL were male sex (OR 2.296 95% CI 1.043–5.055), smoking (OR 4.846, 95% CI 2.376–9.882), hypertension (OR 3.342, 95% CI 1.423–7.852), urinary incontinence (OR 2.291, 95% CI 0.689–7.618) and recurrent urinary tract infections (OR 4.673, 95% CI 2.271–9.614). The area under the ROC curve was 0.802 (IC 95% 0.7307–0.8736), meaning our model can correctly classify an individual with ESBL-producing E. coli infection in 80.2% of cases. |
| Databáze: | OpenAIRE |
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