Investigation of carriage of the same strain in feces in Urinary System Infections Caused by Extended Spectrum Beta-Lactamase Producing Escherichia coli Strains
Research Article
DOI:
https://doi.org/10.5281/zenodo.8313339Keywords:
Urinary Tract İnfection, Faecal Colonisation, ESBL Producing E. coliAbstract
Introduction-Objective: We aimed to determinate the risk factors, contribution of fecal carriage to the infection and precautions to be taken in the prevention of infection in (+) E. coli-induced UTIs in urinary tract infections (UTI) caused by ESBL (+) E. coli
Method: This study was designed as a single-center, prospective and cross-sectional. 64 patients between the ages of 18-79 who were hospitalized and ESBL(+) E.coli isolated in their urine culture were included. Stool samples taken from the patients (0,3,5 and 7 days) were inoculated on EMB agar containing cefotaxime and ceftazidime and IMVIC was used to identify colonies. Strains determined as E. coli according to their reproductive characteristics were included in the study. Phenotypic confirmation tests for the detection of ESBL(+) strains. Genotyping was performed using the ERIC PCR method. Descriptive statistics were expressed as numbers and percentages. Chi-square and trend chi-square tests were used for analytical comparisons. A P value of <0.05 was considered statistically significant.
Results: Of the 64 patients 40 (62.5%) were female and the mean age was 56.5 ± 17.5 (18-79). 47 (69%) were diagnosed with CA- UTI, and 17 (31%) with HA-UTI. Having more than three episodes per year and presence of a foreign device were found to be a risk factor for CA- ESBL (+) E. coli-induced UTI (p:0.035and 0.006). It was found that faecal colonization of ESBL (+) E. coli persisted in 15 (23%) of 64 patients after UTI treatment, and, of them 20% (n: 3) was in the same phylogenetic class with the ERIC PCR method. Faecal colonization was found to be significantly higher in patients with invasive intervention in the previous year (p:0.037).
Conclusion: Unnecessary antibiotic use should be avoided due to resistant infections and increased colonization. The importance of fecal colonization in infections with ESBL-producing bacteria (especially UTI) has been demonstrated in studies. More prospective studies are needed to understand the epidemiology of ESBL enzyme types.
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