Risk Factors for the Development of Extended-Spectrum Beta-Lactamase-Producing Bacteria in Nonhospitalized Patients

  • R. Colodner
  • W. Rock
  • B. Chazan
  • N. Keller
  • N. Guy
  • W. Sakran
  • R. Raz


Although the risk factors for acquiring infection by extended-spectrum beta-lactamase (ESBL)-producing bacteria have been investigated in hospitalized patients, such risk factors have not been defined in the community setting. In this study, clinical data from a total of 311 nonhospitalized patients with community-acquired urinary tract infection (128 with ESBL-positive strains and 183 with ESBL-negative strains) were obtained. According to a multivariate analysis, the following were identified as independent risk factors: previous hospitalization in the past 3 months (OR=8.95, 95%CI, 3.77–21.25), antibiotic treatment in the past 3 months (OR=3.23, 95%CI, 1.76–5.91), age over 60 years (OR=2.65, 95%CI, 1.45–4.83), diabetes (OR=2.57, 95%CI, 1.20–5.51), male gender (OR=2.47, 95%CI, 1.22–5.01), Klebsiella pneumoniae infection (OR=2.31, 95%CI, 1.17–4.54), previous use of third-generation cephalosporins (P=0.014, OR=15.8, 95%CI, 1.7–143), previous use of second-generation cephalosporins (P<0.0001, OR=10.1, 95%CI, 4.2–24), previous use of quinolones (P=0.001, OR=4.1, 95%CI, 1.8–9.0), and previous use of penicillin (P=0.003, OR=4.0, 95%CI, 1.6–9.0).


Urinary Tract Infection Independent Risk Factor Cephalosporin Quinolones Nitrofurantoin 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



The authors thank Idit Lavie for performing the statistical analysis. This work complies with the current laws of Israel regarding clinical trials.


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Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • R. Colodner
    • 1
  • W. Rock
    • 6
  • B. Chazan
    • 2
    • 4
  • N. Keller
    • 3
  • N. Guy
    • 4
  • W. Sakran
    • 2
    • 5
    • 6
  • R. Raz
    • 2
    • 6
  1. 1.Clinical Microbiology LaboratoryHa’Emek Medical CenterAfulaIsrael
  2. 2.Infectious Diseases UnitHa’Emek Medical CenterAfulaIsrael
  3. 3.Sheba Medical CenterTel HashomerIsrael
  4. 4.Department of Family MedicineHa’Emek Medical CenterAfulaIsrael
  5. 5.Pediatric B WardHa’Emek Medical CenterAfulaIsrael
  6. 6.The Rappaport Faculty of MedicineThe TechnionHaifaIsrael

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