Association Between Proton Pump Inhibitor Use and Extended-Spectrum Beta-Lactamase Urinary Tract Infection in Adults: A Retrospective Study
| Autor: | Purayil,Nishan Kunnummal, Naushad,Vamanjore A, Chandra,Prem, Joseph,Prakash, Khalil,Zahida, Zahid,Muhammad, Wilson,Godwin, Kayakkool,Muhammed Kunhi, Ayari,Basma, Chalihadan,Sajid, Elmagboul,Emad Bashier I, Doiphode,Sanjay H |
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| Jazyk: | angličtina |
| Rok vydání: | 2023 |
| Předmět: | |
| Zdroj: | Infection and Drug Resistance. |
| ISSN: | 1178-6973 9745-5792 |
| Popis: | Nishan Kunnummal Purayil,1â 3 Vamanjore A Naushad,1â 3 Prem Chandra,4 Prakash Joseph,1,2 Zahida Khalil,1,2 Muhammad Zahid,1,3 Godwin Wilson,3,5 Muhammed Kunhi Kayakkool,1â 3 Basma Ayari,1,3 Sajid Chalihadan,1 Emad Bashier I Elmagboul,5 Sanjay H Doiphode3,5 1General Internal Medicine Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar; 2Clinical Department, College of Medicine-QU Health, Qatar University, Doha, Qatar; 3Department of Clinical Medicine, Weill Cornell Medicine-Qatar, Doha, Qatar; 4Medical Research Center, Hamad Medical Corporation, Doha, Qatar; 5Department of Microbiology, Hamad Medical Corporation, Doha, QatarCorrespondence: Nishan Kunnummal Purayil, General Internal Medicine Department, Hamad General Hospital, Post Box No-3050, Hamad Medical Corporation, Doha, Qatar, Tel +97455792180, Email nishankp@live.comPurpose: To study the association between proton pump inhibitor (PPI) use and the risk of urinary tract infection (UTI) caused by extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL).Patients and Methods: A retrospective cross-sectional study was conducted between October 2018 and September 2019. Adults with ESBL-UTIs were compared to adults with UTIs caused by gram-negative bacteria (GNB) and those with UTIs caused by miscellaneous organisms. The association between ESBL infection and PPI use was assessed.Results: A total of 117 of 277 ESBL cases, 229 of 679 non-ESBL GNB controls, and 57 of 144 non-ESBL miscellaneous controls were exposed to PPIs within 3 months prior to admission. The univariate analysis indicated unadjusted odds ratio for PPI exposure with ESBL infection versus the GNB controls was 1.43 (95% CI 1.07â 1.90, P = 0.015) while the odds ratio for PPI exposure with ESBL infection versus miscellaneous organisms was 1.10 (95% CI 0.73â 1.67, P = 0.633) indicating positive association (PPI exposure increases risk of ESBL infection). Multivariate analysis revealed a positive association between ESBL infection and PPI use versus the GNB controls with an odds ratio of 1.74 (95% CI 0.91â 3.31). While Esomeprazole was positively associated with ESBL infection, particularly compared with the miscellaneous group (adjusted OR 1.35, 95% CI 0.47â 3.88), Lansoprazole was inversely associated (adjusted OR 0.48, 95% CI 0.18â 1.24 and adjusted OR 0.40, 95% CI 0.11â 1.41 for ESBL versus GNB controls and ESBL versus miscellaneous organisms, respectively).Conclusion: Exposure to PPIs in the preceding 3 months showed an association with increased risk of ESBL-UTI. While Esomeprazole showed a positive association, Lansoprazole had an inverse association for ESBL-UTI. Restricting the use of PPIs may be beneficial in the fight against antimicrobial resistance.Keywords: proton pump inhibitor, PPI, ESBL, extended-spectrum beta-lactamase, urinary tract infections |
| Databáze: | OpenAIRE |
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