Recurrence of Urinary Tract Infections due to Escherichia coli and Its Association with Antimicrobial Resistance

Maria Angeles Ormeño, Maria José Ormeño, Antonio M. Quispe, Miguel Angel Arias-Linares, Elba Linares, Felix Loza, Joaquim Ruiz, Maria J. Pons

Research output: Contribution to journalArticlepeer-review

Abstract

We analyzed the association between antibiotic resistance and recurrent urinary tract infection (rUTI) by Escherichia coli. Susceptibility levels to 14 antimicrobial agents and the presence of extended-spectrum β-lactamases (ESBL) were established using MicroScan. Incidences of multidrug resistant (MDR), extensively drug resistant (XDR), and ESBL-producer isolates as well as rUTIs were estimated. The time to recurrence was established adjusted for number of antibiotic-resistant families and MDR as predictors of interest, respectively. Overall, 8,553 urinary tract infection (UTI) cases related to E. coli, including 963 rITU, were analyzed with levels of resistance >30% in all cases, except for amikacin, nitrofurantoin, and carbapenems. The incidence of rUTI was of 11.3%, being 46.5%, 24.3%, and 42.5% for MDR, XDR, and ESBLs, respectively. Bivariate analysis showed that rUTI was associated with age, gender, resistance to specific antimicrobials, MDR, and XDR. The number of antibiotic families tested as resistant, MDR, XDR, gender, and age were associated with time to recurrence when adjusted for number of antibiotic families, and MDR, gender, and age were related when adjusted for MDR. High rates of antibiotic resistance to the usual antibiotics was observed in E. coli causing UTI, with female sex, age, and antibiotic resistance being risk factors for the development of rUTI.

Original languageEnglish
Pages (from-to)185-190
Number of pages6
JournalMicrobial Drug Resistance
Volume28
Issue number2
DOIs
StatePublished - Feb 2022

Keywords

  • Escherichia coli
  • antibiotic resistance
  • multidrug resistance
  • recurrence
  • urinary tract infection

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