Risk factors for community-acquired urinary tract infection due to quinolone-resistant E. coli.Infection. 2008 Feb; 36(1):41-5.I
Resistance to fluoroquinolone drugs is emerging among E. coli causing community acquired urinary tract infections (COMA-UTI).
To evaluate demographic and clinical risk factors associated with COMA-UTI due to quinolone-resistant E. coli (QREc).
In this case-control study, clinical and demographic data from 300 COMA-UTI due to E. coli (including 150 QREc) were analyzed.
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.
In patients with one or more of the risk factors identified here, the empiric use of quinolones should be reconsidered.