Annals of Clinical Microbiology, The official Journal of the Korean Society of Clinical Microbiology

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pISSN 2288-0585 eISSN 2288-6850

Risk Factors Associated with Recurrent Urinary Tract Infection Caused by Escherichia coli

Original article

Annals of Clinical Microbiology (Ann Clin Microbiol) 2021 March, Volume 24, Issue 1, pages 11-20.

https://doi.org/10.5145/ACM.2021.24.1.2

Risk Factors Associated with Recurrent Urinary Tract Infection Caused by Escherichia coli

Young Ah Kim1, Ea Wha Kang2, Young Hee Seo3, Kyungwon Lee3,4
1Department of Laboratory Medicine, 2Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang, 3Research Institute of Bacterial Resistance and 4Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea

Abstract

Background: The purpose of this study was to analyze the clinical and microbiological characteristics of recurrent urinary tract infection (UTI) caused by Escherichia coli— the most common etiological agent.

Methods: Cases of recurrent and single episodes of UTI caused by E. coli were evaluated retrospectively for a period of 6 months (January-June 2019) to analyze the clinical and molecular characteristics of this disease.

Results: Healthcare-associated UTI, E. coli bacteremia, and poor microbial clearance 7 days post infection were associated more with the recurrent episodes of infection. E. coli isolates from subjects with recurrent UTIs showed higher rates of antimicrobial resistance and extended-spectrum β-lactamase (ESBL) production. The E. coli clone— sequence type 131 was detected in similar proportions in isolates, recovered from subjects in both groups— recurrent episodes and single episode of UTI.

Conclusion: The control of antimicrobial-resistant ESBL-producing E. coli strains may be difficult using antimicrobial therapy and subsequently delay the clearance of the etiologic agent. This could play a major role in the development of recurrent UTIs.

Keywords

Escherichia coli, Extended-spectrum β-lactamases, Recurrent urinary tract infection, Risk factors, Sequence type 131