Spatial clusters of extended-spectrum beta-lactamase-producing Escherichia coli causing community-onset bacteriuria due to repeat infections: cluster analysis from a large urban medical center, San Francisco, 2014-2020

Author:

Raphael Eva1,Inamdar Pushkar P.1,Belmont Cheyenne1,Shariff-Marco Salma1,Huang Alison1,Chambers Henry1

Affiliation:

1. University of California, San Francisco

Abstract

Abstract Background Urinary tract infections caused by extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli (ESBL-E. coli) may occur as outbreaks due to common-source exposures. Yet, it is currently unknown if they cluster geographically as would be expected as part of an outbreak. Methods We collected electronic health record data on all patients living in San Francisco with culture-documented community-onset E. coli bacteriuria in a safety-net public healthcare system from January 2014 to March 2020 (diagnosed < 48 hours after hospital admission or in outpatient clinical settings without a hospitalization in the past 90 days). We assessed the presence of spatial clusters of (1) ESBL-E. coli bacteriuria episodes, and (2) individuals with any ESBL-E. coli bacteriuria episode, with Global and Local Moran’s I. We evaluated differences in prevalence of bacteriuria recurrence by ESBL-production by Poisson regression. Results Out of 4,304 unique individuals, we identified spatial clusters of ESBL-E. coli bacteriuria episodes (n = 461) compared to non-ESBL-E. coli bacteriuria episodes (n = 5477; Global Moran’s p < 0.001). Spatial clusters of individuals with any bacteriuria caused by ESBL-E. coli were not identified (p = 0.43). Bacteriuria recurrence was more likely to occur with ESBL-E. coli (odds ratio [OR] 2.78, 95% confidence interval [95% CI] 2.10, 3.66, p < 0.001), particularly after an initial ESBL-E. coli bacteriuria episode (OR 2.27, 95% CI 1.82, 2.83, p < 0.001). Conclusion We found spatial clusters of ESBL-E. coli bacteriuria episodes. However, this was partly explained by clustering within individuals more than between individuals, as having an ESBL-E. coli bacteriuria was associated with recurrence with ESBL-E. coli.

Publisher

Research Square Platform LLC

Reference35 articles.

1. CDC. Antibiotic Resistance Threats in the United States, 2019. Atlanta. GA: U.S. Department of Health and Human Services, CDC; 2019.

2. Changing epidemiology of infections due to extended spectrum beta-lactamase producing bacteria;Kassakian SZ;Antimicrob Resist Infect Control,2014

3. Antibiotic resistance of Escherichia coli isolated from uncomplicated UTI in general practice patients over a 10-year period;Driel AA;Eur J Clin Microbiol Infect Dis,2019

4. Extended-spectrum beta-lactamase-producing Enterobacteriaceae: an emerging public-health concern;Pitout JD;Lancet Infect Dis,2008

5. Increasing resistance in community-acquired urinary tract infections in Latin America, five years after the implementation of national therapeutic guidelines;Bours PH;Int J Infect Dis,2010

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