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Risk factors for non-Escherichia coli community-acquired bacteriuria
1Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
Infection
|October 12, 2012
Summary
This study identified five key risk factors for community-acquired bacteriuria (CA-Bu) not caused by E. coli. These factors are crucial for guiding empiric antibiotic treatment in adult outpatients with CA-Bu.
Area of Science:
- Urology
- Infectious Diseases
- Epidemiology
Background:
- Urinary tract infections (UTIs) are common bacterial infections, with Escherichia coli (E. coli) being the predominant cause of community-acquired bacteriuria (CA-Bu).
- While E. coli's role in UTIs is well-studied, risk factors for CA-Bu caused by other uropathogens remain less understood.
- This study aimed to elucidate the current knowledge on risk factors for non-E. coli CA-Bu.
Purpose of the Study:
- To identify independent risk factors associated with community-acquired bacteriuria (CA-Bu) caused by uropathogens other than Escherichia coli (E. coli) in adult outpatients.
- To provide data that can inform clinical decision-making regarding empiric antibiotic therapy for UTIs.
- To update the understanding of CA-Bu epidemiology beyond E. coli.
Main Methods:
- A clinical epidemiological study was conducted involving adult ambulatory patients.
- Urine cultures submitted to the Microbiology Laboratory during November 2009 were analyzed.
- Data collected included patient demographics, underlying diseases, and antibiotic treatments, analyzed using SPSS.
Main Results:
- Out of 4,653 urine cultures, 1,047 (22.5%) were positive, with 838 included in the study. Most positive cultures (82.5%) were from females.
- E. coli was the most frequent pathogen (58.6% of positive cultures).
- Multivariate analysis revealed five independent risk factors for non-E. coli CA-Bu: presence of a urinary tract foreign body (OR 5.8), negative nitrite test (OR 3.2), male gender (OR 2.5), normal erythrocyte count (OR 1.5), and recurrent UTI history (OR 1.5).
Conclusions:
- Five independent risk factors were identified for adult outpatients with CA-Bu involving uropathogens other than E. coli.
- These factors include urinary tract foreign body, negative nitrite test, male gender, normal erythrocyte count, and recurrent UTIs.
- Clinicians should consider these factors when prescribing empiric antibiotic treatment for CA-Bu.
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