Risk factors and treatment approaches for urinary tract infections caused by community and hospital acquired extended spectrum beta-lactamase producing escherichia coli and klebsiella pneumoniae

Objective: In recent years, extended-spectrum betalactamase (ESBL) producing microorganisms are responsible not only for healthcare-associated but also for community-acquired urinary tract infections (UTI). The aim of this study is to evaluate the risk factors of community acquired and healthcare associated UTI caused by ESBL producing Escherichia coli and Klebsiella pneumoniae and treatment options in outpatients and inpatients. Material and Method: In this study 200 patients with UTI caused by ESBL producing E.coli and K.pneumoniae followed up between 1 January 2012 and 31 December 2013 at Selcuk University Faculty of Medicine Hospital were evaluated with file review. Results: Compared to community-acquired UTI presence of underlying disease, previous antibiotic use, urinary catheterization, hospital admission in the last 6 months were more common in healthcare associated infection When inpatient treatment was evaluated imipenem was more commonly used in healthcare associated infections and when outpatient treatment was evaluated the combination of nitrofurantoin and fosfomycin was more commonly used in community acquired infections. Conclusion: The presence of underlying disease, history of antibiotic use in the past month, hospital admission in the last 6 months and urinary catheterization were highlights in healthcare associated UTI caused by ESBL producing microorganisms. Carbapenems were seen the first choice in the treatment of these infections. According to clinical and laboratory findings, combination of nitrofurantoin and fosfomycin was seen to be o good alternative for treatment of outpatients with UTI caused by ESBL producing E.coli and K.pneumoniae.