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Risk Factors Associated with Community-Acquired Urinary Tract Infections Caused by Extended-Spectrum β-Lactamase-Producing Escherichia coli: a Systematic Review

  • Infectious Disease Epidemiology (A Reingold, Section Editor)
  • Published:
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Abstract

Purpose of Review

This review aims to characterize the current body of knowledge regarding risk factors for community-acquired urinary tract infection (CA-UTI) caused by extended-spectrum β-lactamase-producing (ESBL) uropathogenic Escherichia coli (UPEC). Our purpose is to identify major knowledge gaps, suggest potential areas for improved public health intervention, and propose future research directions.

Recent Findings

This review contains two parts. Part one reviews 15 studies that included 2,930 ESBL-producing UPEC infections in 10 countries. Of the 103 risk factors for these infections examined, only two of eight commonly-assessed factors demonstrated concordant significant results across studies. Part two focuses on 19 studies that examined 2,042 ESBL-producing extraintestinal pathogenic E. coli (ExPEC) strains isolated from environmental, food, or animal sources and discovered evidence for occurrence of all six pandemic ExPEC lineages associated with CA-UTI in these sources.

Summary

This review has demonstrated inconsistent evidence regarding patient level risk factors associated with CA-UTI caused by ESBL-producing UPEC. However, reviewed studies reveal exposures to food, animal, or environmental sources to be potential risk factors for infection with common ESBL-producing E. coli.

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Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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  1. School of Public Health, Division of Epidemiology, University of California Berkeley, 530E Li Ka Shing, Berkeley, CA, 94720, USA

    Cheyenne R. Butcher & Julia Rubin

  2. School of Public Health, Division of Environmental Health Sciences, University of California Berkeley, 530E Li Ka Shing, Berkeley, CA, 94720, USA

    Kaitlyn Mussio

  3. School of Public Health, Division of Infectious Disease and Vaccinology, University of California Berkeley, 530E Li Ka Shing, Berkeley, CA, 94720, USA

    Lee W. Riley

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Butcher, C.R., Rubin, J., Mussio, K. et al. Risk Factors Associated with Community-Acquired Urinary Tract Infections Caused by Extended-Spectrum β-Lactamase-Producing Escherichia coli: a Systematic Review. Curr Epidemiol Rep 6, 300–309 (2019). https://doi.org/10.1007/s40471-019-00206-4

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