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Volume 22, Number 9—September 2016
CME ACTIVITY - Research

Fluoroquinolone-Resistant and Extended-Spectrum β-Lactamase–Producing Escherichia coli Infections in Patients with Pyelonephritis, United States1

David A. TalanComments to Author , Sukhjit S. Takhar, Anusha Krishnadasan, Fredrick M. Abrahamian, William R. Mower, Gregory J. Moran, and EMERGEncy ID Net Study Group
Author affiliations: David Geffen School of Medicine at the University of California, Los Angeles (UCLA), Los Angeles, California, USA (D.A. Talan, A. Krishnadasan, F.M. Abrahamian, W.R. Mower, G.J. Moran); Olive View–UCLA Medical Center, Los Angeles (D.A. Talan, A. Krishnadasan, F.M. Abrahamian, G.J. Moran); Brigham and Women’s Hospital, Boston, Massachusetts, USA (S.S. Takhar); Harvard Medical School, Boston (S.S. Takhar); Ronald Reagan Medical Center, Los Angeles (W.R. Mower)

Main Article

Table 5

Factors associated with ESBL production among 453 US emergency department patients with pyelonephritis caused by Escherichia coli, July 2013–December 2014*

Factor ESBL-producing E. coli rate
 Relative risk (95% CI)
Factor present, no./total (%) Factor absent, no./total (%)
Age >65 y 4/22 (18.2) 25/431 (5.8) 3.1 (0.96–8.1)
Complicated infection
 22/181 (12.2)
 7/272 (2.6)
 4.7 (2.0–12.0)
Prior antimicrobial drugs
Within past 60 d 16/94 (17.0) 13/359 (3.6) 4.7 (2.2–10.0)
Within past 2 d
 4/27 (14.8)
 25/426 (5.9)
 2.5 (0.8–6.7)
IV antimicrobial drugs taken within past 30 d 4/26 (15.4) 25/425 (5.9) 2.6 (0.8–6.9)
LTC within past 90 d 1/3 (33.3) 28/450 (6.2) 5.4 (0.3–14.9)
Hospital admittance within past 90 d 5/42 (11.9) 24/411 (5.8) 2.0 (0.7–5.2)
Travel outside United States within past 90 d
 4/17 (23.5)†
 25/436 (5.7)
 4.1 (1.3–10.1)
UTI caused by fluoroquinolone-resistant E. coli
Within past year 5/9 (55.6) 24/444 (5.4) 10.3 (3.8–17.5)
Within past 90 d
 5/8 (62.5)
 24/445 (5.4)
 11.6 (4.4–18.3)
UTI caused by ceftriaxone-resistant E. coli
Within past year 5/6 (83.3) 24/447 (5.4) 15.5 (6.2 −19.2)
Within past 90 d
 5/5 (100.0)
 24/448 (5.4)
 18.7 (8.0–18.7)
Fluoroquinolone resistance 24/53 (45.3) 5/400 (1.3) 36.2 (14.2–104.7)

*Denominators differ because factors have a different distribution among the patient population. ESBL, extended spectrum β-lactamase; IV, intravenous; LTC, residence in a long-term care facility; UTI, urinary tract infection.
†Of these 4 patients who traveled to other regions, 3 traveled to Mexico or Central America and 1 traveled to Asia.

Main Article

1Preliminary results of this research were presented at the 2014 IDWeek Meeting, Philadelphia, PA, USA, October 8–12, 2014.

Page created: August 11, 2016
Page updated: August 11, 2016
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