PREVALENCE AND RISK FACTORS OF EXTENDED SPECTRUM BETA LACTAMASE ORGANISMS IN COMMUNITY-ACQUIRED URINARY TRACT INFECTIONS IN LEBANON: A CASE CONTROL STUDY

Abstract

Summary In Lebanon, clinical information about community-acquired urinary tract infections (CAUTI) caused by extended-spectrum beta-lactamase (ESBL)-producing Gram negative bacteria (GNB), is scarce. A population based case-control study was conductedwhereby42 cases were matched to 42 controls. The prevalence of ESBL producing strains was 14.15%. Univariate analysis showed two statistically significant independent risk factors for ESBL producing strains: antibiotic use during the last three months (p<0.0001), and urinary catheterization during the last six months (p=0.0034); and one protective factor: age group 18-50 years (p=0.011). Multivariate analysis showed antibiotic use as the strongest predictor for CAUTI due to ESBL-producing GNB. Coresistance of ESBL producing strains to antibiotics was significantly higher compared with non ESBL strains: cprofloxacin (75% vs 21.4%), trimethropin-sulfmaz (71.1% vs 35.7%) and amoxicillin-clavulanate (77.7% vs 9.5%). This study confirms that ESBL-producing GNB strains constitute a notable cause of CAUTI in Lebanon. These results can be used to guide appropriate treatment of CAUTI and targeted infection control measures.