Risk factors for community-acquired urinary tract infection due to quinolone-resistant E. coli.

BACKGROUND

Resistance to fluoroquinolone drugs is emerging among E. coli causing community acquired urinary tract infections (COMA-UTI).

OBJECTIVES

To evaluate demographic and clinical risk factors associated with COMA-UTI due to quinolone-resistant E. coli (QREc).

METHODS

In this case-control study, clinical and demographic data from 300 COMA-UTI due to E. coli (including 150 QREc) were analyzed.

RESULTS

By univariate analysis QREc was associated to males, older patients, nursing home residents, functionally dependent, dementia, diabetes, cardiovascular diseases, immunosupression, nephrolithiasis, recurrent UTI, invasive procedures, hospitalization, and antibiotic use within previous 6 months. By multivariate analysis, use of ciprofloxacin (OR 20.6 [CI 2.3-179.2], p=0.006) or ofloxacin (OR 7.5 [CI 2.9-19.4], p<0.0001), previous invasive procedure (OR 6.6 [CI 3.0-14.7], p<0.0001), recurrent UTI (OR 4.7 [CI 2.3-9.3], p<0.0001), and previous hospitalization (OR 2.9 [CI 1.4-6], p=0.003) were identified as independent risk factors for COMA-UTI due to QREc.

CONCLUSION

In patients with one or more of the risk factors identified here, the empiric use of quinolones should be reconsidered.