Jaimes-Vélez AM, Solís-Ayala E

Language: Spanish
References: 12
Page: 605-611
PDF size: 438.27 Kb.

ABSTRACT

Background: Urinary tract infections caused by gram-negative bacilli producers of extended-spectrum beta-lactamases (ESBL) are a global public health problem.
Material and Method: An analytical, cross-sectional, pilot study was carried out in Nuevo Sanatorio Durango, Mexico City, in which the cases of urinary tract infection in diabetic patients were reviewed. Two groups were compared depending on the result of the urinary culture. Data were collected taking into account the antecedent of antibiotic treatment, glycosylated hemoglobin (Hb1Ac), history of hospitalization, history of urinary catheter (Foley catheter) and diagnosis of chronic kidney disease.
Results: There were included 103 patients, divided according to the result of the urinary culture: E. coli (n = 49) and E. coli ESBL (n = 54). We found a greater association with ESBL-producing urinary tract infections in individuals aged 68 ± 14.04 years. We calculated odds ratios for each of the items, finding a statistically significant association by means of χ² test (p ‹ 0.05), calculating an OR of 10.2 with the antecedent of antibiotic use and a OR of 2.97 with the diagnosis of chronic kidney disease, when there was isolation of E. coli producing ESBL.
Conclusion: There is an association between the use of antibiotic treatment and the presence of chronic kidney disease with E. coli ESBL isolation in community-acquired infections in diabetic patients.

REFERENCES

1. Foxman B. The epidemiology of urinary tract infection. Nature Reviews Urology 2010;7(12):653-660.

2. Stamm WE. Scientific and clinical challenges in the management of urinary tract infections. Am J Med 2002;113(Suppl. 1A):1S-4S.

3. Curello J, MacDougall C. Beyond susceptible and resistant, part II: Treatment of infections due to Gram-negative organisms producing extended-spectrum β-lactamases. J Pediatr Pharmacol Ther 2014;19(3):156-164.

4. CLSI. Performance Standards for Antimicrobial Susceptibility Testing; Twenty-Fifth Informational Supplement. CLSI document M100-S25. Wayne, PA: Clinical and Laboratory Standards Institute, 2015. ISBN 1-56238-989-0.

5. Villegas MV, Kattan JN, Quinteros MG, Casellas JM. Prevalence of extended spectrum beta-lactamases in South America. Clin Microbiol Infect 2008;14(Suppl 1):154-158.

6. Salles MJC, Zurita J, Mejía C, Villegas MV. Resistant Gramnegative infections in the outpatient setting in Latin America. Epidemiology and infection 2013;141(12):2459-2472.

7. Cantón R, González-Alba JM, Galán JC. CTX-M enzymes: origin and diffusion. Front Microbiol 2012;3:110.

8. Aswani SM, Chandrashekar UK, Shivashankara KN, Pruthvi BC. Clinical profile of urinary tract infections in diabetics and non-diabetics. Australas Med J 2014;7(1):29-34.

9. Kanafani ZA, Mehio-Sibai A, Araj GF, Kanaan M, Kanj SS. Epidemiology and risk factors for extended-spectrum β-lactamaseproducing organisms: A case control study at a tertiary care center in Lebanon. Am J Infect Control 2005;33(6):326-32.

10. American Diabetes Association. Glycemic targets. Diabetes Care 2016;39(Suppl 1):S39-46.

11. Ben-Ami R, Rodríguez-Baño J, Arslan H, Pitout JD, et al. A multinational survey of risk factors for infection with extended-spectrum β-lactamase-producing Enterobacteriaceae in nonhospitalized patients. Clin Infect Dis 2009;49(5):682-690.

12. Guzmán-Blanco M, Labarca JA, Villegas MV, Gotuzzo E. Extended spectrum b-lactamase producers among nosocomial Enterobacteriaceae in Latin America. Braz J Infect Dis 2013;18(4).