Skip to main content

ORIGINAL RESEARCH article

Front. Microbiol.
Sec. Infectious Agents and Disease
Volume 15 - 2024 | doi: 10.3389/fmicb.2024.1384392

Urinary Tract Infections in Older Adults: Associated Factors for Extended Spectrum Beta-lactamase Production

Provisionally accepted
Sena Alkan Sena Alkan 1Ilker I. Balkan Ilker I. Balkan 1Serkan Surme Serkan Surme 2Osman Faruk Bayramlar Osman Faruk Bayramlar 3Sibel Y. Kaya Sibel Y. Kaya 1Ridvan Karaali Ridvan Karaali 1Bilgul Mete Bilgul Mete 1Gökhan Aygün Gökhan Aygün 1Fehmi Tabak Fehmi Tabak 1Nese Saltoglu Nese Saltoglu 1*
  • 1 Department of Infectious Diseases and Clinical Microbiology, Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Istanbul, Türkiye
  • 2 Department of Medical Microbiology, Institute of Graduate Studies, Istanbul University-Cerrahpasa, Istanbul, Türkiye
  • 3 Department of Public Health, Bakirkoy District Health Directorate, Istanbul, Türkiye

The final, formatted version of the article will be published soon.

    Objective: Urinary tract infections (UTIs) due to extended spectrum beta lactamase (ESBL) producing Escherichia coli and Klebsiella pneumoniae. are among the leading causes of morbidity and mortality in older adults. Identifying associated factors for ESBL production may contribute to more appropriate empirical treatment.This was a prospective observational study. Hospitalized patients of age >65 with community-onset or hospital-acquired upper UTI due to E. coli or Klebsiella pneumoniae was included. A multivariate analysis was performed.Results: A total of 97 patients were included. ESBL prevalence among UTIs with E. coli or Klebsiella pneumoniae was 69.1% (n=67). CRP values at the time of UTI diagnosis were found to be significantly higher in the ESBL-producing group (p=0.004). Multivariate analysis revealed that male gender (OR:2.72, CI:1.02-7.25), prior recurrent UTI (OR:3.14, CI:1.21-8.14), and development of secondary bacteremia (OR:4.95, CI:1.03-23.89) were major asssociated factors for UTI in older adults due to ESBL-producing E. coli and Klebsiella pneumoniae. Severe UTI in older men with a history of recurrent UTI may be a warning to the clinician for ESBL production in the setting of high ESBL prevalence. Carbapenems may be prioritized in the empirical treatment in patients with known risk factors for ESBL.

    Keywords: Urinary tract infection, extended spectrum beta-lactamase, Escherichia coli, Klebsiella pneumoniae, Associated factors

    Received: 09 Feb 2024; Accepted: 17 Apr 2024.

    Copyright: © 2024 Alkan, Balkan, Surme, Faruk Bayramlar, Kaya, Karaali, Mete, Aygün, Tabak and Saltoglu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Nese Saltoglu, Department of Infectious Diseases and Clinical Microbiology, Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Istanbul, Türkiye

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.