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Extended-Spectrum Beta-Lactamase-Producing Bacteria in a Urology Ward: Epidemiology, Risk Factors and Antimicrobial Susceptibility Patterns

2015; Karger Publishers; Volume: 95; Issue: 3 Linguagem: Inglês

10.1159/000439441

1423-0399

José Medina‐Polo, Ana Arrébola‐Pajares, S. Pérez-Cadavid, R. Benítez-Sala, Raquel Sopeña Sutil, A. Lara-Isla, Manuel Alonso-Isa, J. Gil-Moradillo, J. Justo-Quintas, N. Miranda-Utrera, L. Aguilar-Gisbert, J.B. Passas-Martínez, Á. Tejido Sánchez,

Antibiotic Use and Resistance

<b><i>Introduction:</i></b> Our aim was to describe the incidence and risk factors associated with extended-spectrum beta-lactamase (ESBL)-producing <i>Enterobacteriaceae</i> and their resistance rate in a urological ward. <b><i>Material and Methods:</i></b> We carried out a prospective observational study from November 2011 to December 2014, reviewing healthcare-associated infections (HAIs) in our department. We evaluated the infections caused by ESBL-producing <i>Enterobacteriaceae</i>. <b><i>Results:</i></b> The incidence of HAIs in our urology ward was 6.8%. <i>Enterobacteriaceae</i> including <i>Escherichia coli</i> (24.9%), <i>Klebsiella </i>spp. (12.1%), <i>Enterobacter </i>spp. (5.9%), <i>Morganella </i>spp. (1.5%), <i>Proteus </i>spp. (1.5%), and <i>Citrobacter </i>spp. (1.5%) represented 47.4% of the isolated pathogens. The percentage of ESBL-producing Enterobacteriaceae was 26.4. Risk factors associated with a higher incidence of ESBL-producing bacteria were prior urinary tract infection (UTI; p < 0.001), hypertension (p = 0.042), immunosuppression (p = 0.004), and urinary stone (p = 0.027). The multivariable analysis confirmed prior UTI, immunosuppression and urinary stone as risk factors. ESBL-producing strains showed resistance rates of 85.3% for fluoroquinolones and 11.8% for carbapenems. Moreover, 16.7% of ESBL-<i>Klebsiella</i> were resistant to carbapenems. <b><i>Conclusions:</i></b> ESBL-producing enterobacteria are associated with higher cross resistance to antibiotics such as quinolones. Higher resistance rates are reported in ESBL-producing <i>Klebsiella</i>. Among patients admitted in a urology ward, risk factors for ESBL-producing strains were previous UTI, immunosuppression, and urinary stone.