An outbreak of multi-drug resistant Escherichia coli urinary tract infection in an elderly population: a case-control study of risk factors

BMC Infectious Diseases

Research Article

Patricia Priest¹  Rebecca Psutka¹  Alison Carter²  Rosemary Ikram² 

[1] Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand;Microbiology, Christchurch School of Medicine University of Otago, Christchurch, New Zealand;

关键词: Drug resistance;    Bacterial;    Hospital;    Nursing home;    Risk factors;    Antimicrobial prescribing;    UTI;    Escherichia coli;   

DOI  :  10.1186/s12879-015-0974-0

 received in 2015-04-28, accepted in 2015-05-29,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundPrevention of infection due to multi-drug resistant organisms is particularly challenging because of the spread of resistant bacteria beyond hospitals into the community, including nursing homes. This study aimed to identify risk factors for the acquisition of a multidrug resistant (MDR) Escherichia coli in a local outbreak.MethodsStudy participants were all aged over 65 years. Cases had the MDR E. coli isolated from a routine urine sample, and controls had a urine sample submitted to the laboratory in the same time period but the MDR E. coli was not isolated. Information from clinical records was used to identify risk factors both in the hospital and the community setting for acquisition of the MDR E. coli.Results76 cases and 156 controls were identified and included in the study. In a multivariate analysis, risk factors statistically significantly associated with acquisition of the MDR E. coli were female gender (adjusted OR 3.2; 95 % confidence interval 1.5–6.9), level of care (high dependency OR 7.5; 2.2–25.7) compared with living independently), and in hospital prescription of antimicrobials to which the MDR E. coli was resistant (OR 5.6; 2.5-12.9).ConclusionsThe major risk factors for the acquisition of a MDR E. coli were found to be residence in a nursing home and in-hospital prescription of antimicrobials to which the MDR E. coli was resistant. This emphasises that prevention of transmission of MDROs within a community needs to involve both hospitals and also other healthcare organizations, in this case nursing homes.

【 授权许可】

Unknown   
© Ikram et al. 2015. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.