Clinical and epidemiological characterization of urinary tract infections caused by extended-spectrum beta-lactamase-producing Enterobacterales
Keywords:
beta-lactamases; enterobacteria; Escherichia coli infection; urinary tract; antibiotic resistanceAbstract
Introduction: The inappropriate use of antibiotics to treat urinary tract infections has contributed to the increase in bacterial resistance, making it necessary to obtain accurate and systematic data for epidemiological surveillance.
Objective: To determine the clinical and epidemiological characteristics of urinary tract infections caused by extended-spectrum beta-lactamase-producing Enterobacteriaceae.
Methods: A descriptive, prospective study was conducted with a sample of 384 outpatients treated at the General Hospital of Jaén. Urine samples were analyzed from patients with urinary tract infections of both sexes and over 18 years of age. Enterobacteriaceae were identified biochemically. The Jarlier technique was used for the phenotypic determination of beta-lactamases. Clinical and epidemiological characteristics were collected using a structured and validated questionnaire.
Results: Enterobacteriaceae such as Escherichia coli (44.01%), Klebsiella sp. (18.49%), and Proteus sp. (14.84%) were the most frequently identified. 41.93% of isolates were beta-lactamase-producing strains. 60.68% of patients with urinary tract infections were between 27 and 59 years old. Among the clinical characteristics, 57.03% presented with recurrent urinary tract infections, with 22.9% testing positive for beta-lactamases. The most common symptoms were lower back and pelvic pain and dysuria. 25.8% of patients who did not complete medical treatment presented with infection caused by beta-lactamase-producing Enterobacteriaceae.
Conclusion: The Enterobacteriaceae with the highest beta-lactamase production was Escherichia coli. The associated clinical characteristics are recurrent urinary tract infections and incomplete medical treatment. No relationship was found between epidemiological characteristics and urinary tract infections caused by extended-spectrum beta-lactamases in Enterobacterales.
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