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dc.creatorRodríguez-Baño, Jesúses
dc.creatorDolores Navarro, Maríaes
dc.creatorRomero, Luisaes
dc.creatorMartínez-Martínez, Luises
dc.creatorMuniain Ezcurra, Miguel Angeles
dc.creatorPerea J., Evelioes
dc.creatorPérez Cano, Ramónes
dc.creatorPascual Hernández, Álvaroes
dc.date.accessioned2016-05-12T17:54:34Z
dc.date.available2016-05-12T17:54:34Z
dc.date.issued2004-03
dc.identifier.issn0095-1137es
dc.identifier.urihttp://hdl.handle.net/11441/41127
dc.description.abstractInfections due to extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli (ESBLEC) in nonhospitalize patients seem to be emerging in different countries. Their incidence, epidemiology, and clinical impact in the community have not been studied. We describe the epidemiology and clinical features of infections caused by ESBLEC in nonhospitalized patients in Spain and the results of a case-control study performed to investigate the risk factors associated with the acquisition of these organisms. The clonal relatedness of the organisms was assessed by repetitive extragenic palindromic sequence PCR. The ESBLs and the genes encoding the ESBLs were initially characterized by isoelectric focusing and PCR, respectively. Forty-nine patients (76% with urinary tract infections, 22% with asymptomatic bacteriuria, and 2% with acute cholangitis) were included. Six patients were bacteremic. Diabetes mellitus (odds ratio, 5.5; 95% confidence interval, 1.6 to 18.7), previous fluoroquinolone use (odds ratio, 7.6; 95% confidence interval, 1.9 to 30.1), recurrent urinary tract infections (odds ratio, 4.5; 95% confidence interval, 1.3 to 15.1), a previous hospital admission (odds ratio, 18.2; 95% confidence interval, 5.3 to 61.1), and older age in male patients (odds ratio per year, 1.03; 95% confidence interval, 1.03 to 1.05) were identified as risk factors by multivariate analysis. The ESBLEC isolates were not clonally related. The ESBLs were characterized as members of the CTX-M-9 group, the SHV group, and the TEM group in 64, 18, and 18% of the isolates, respectively. ESBLEC is an emergent cause of urinary tract infections in nonhospitalized patients. There was no evidence of horizontal transmission of ESBLEC strains. Avoidance of fluoroquinolone use in high-risk patients should be considered whenever possible in order to avoid the selection of these organisms.es
dc.formatapplication/pdfes
dc.language.isoenges
dc.publisherAmerican Society for Microbiologyes
dc.relation.ispartofJournal of Clinical Microbiology, 42(3), 1089–1094es
dc.rightsAttribution-NonCommercial-NoDerivatives 4.0 Internacional*
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/*
dc.titleEpidemiology and Clinical Features of Infections Caused by Extended-Spectrum Beta-Lactamase-Producing Escherichia coli in Nonhospitalized Patientses
dc.typeinfo:eu-repo/semantics/articlees
dc.type.versioninfo:eu-repo/semantics/publishedVersiones
dc.rights.accessrightsinfo:eu-repo/semantics/openAccesses
dc.contributor.affiliationUniversidad de Sevilla. Departamento de Medicinaes
dc.contributor.affiliationUniversidad de Sevilla. Departamento de Microbiologíaes
dc.relation.publisherversionhttp://dx.doi.org/10.1128/jcm.42.3.1089-1094.2004es
dc.identifier.doihttp://dx.doi.org/10.1128/jcm.42.3.1089-1094.2004es
idus.format.extent6 p.es
dc.identifier.idushttps://idus.us.es/xmlui/handle/11441/41127

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