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

Young Ah Kim1   Ea Wha Kang2   Young Hee Seo3   Kyungwon Lee3, 4*   

1 Department of Laboratory Medicine, National Health Insurance Service Ilsan Hospital, Goyang,
2 Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang,
3 Research Institute of Bacterial Resistance, Yonsei University College of Medicine, Seoul,
4 Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul,

* Corresponding author: Tel: +82-31-900-0908, Fax: +82-31-900-0925, E-mail: yakim@nhimc.or.kr

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.

Figures & Tables

Fig. 1. Antimicrobial resistance rates of Escherichia coli. Total UTI (n = 124) included both recurrent episodes (n = 62) and single episodes (n = 62).