Risk factors for community-acquired urinary tract infection due to quinolone-resistant E. coli

Infection. 2008 Feb;36(1):41-5. doi: 10.1007/s15010-007-7083-y. Epub 2008 Jan 12.


Background: Resistance to fluoroquinolone drugs is emerging among E. coli causing community acquired urinary tract infections (COMA-UTI).

Objectives: To evaluate demographic and clinical risk factors associated with COMA-UTI due to quinolone-resistant E. coli (QREc).

Methods: In this case-control study, clinical and demographic data from 300 COMA-UTI due to E. coli (including 150 QREc) were analyzed.

Results: By univariate analysis QREc was associated to males, older patients, nursing home residents, functionally dependent, dementia, diabetes, cardiovascular diseases, immunosupression, nephrolithiasis, recurrent UTI, invasive procedures, hospitalization, and antibiotic use within previous 6 months. By multivariate analysis, use of ciprofloxacin (OR 20.6 [CI 2.3-179.2], p=0.006) or ofloxacin (OR 7.5 [CI 2.9-19.4], p<0.0001), previous invasive procedure (OR 6.6 [CI 3.0-14.7], p<0.0001), recurrent UTI (OR 4.7 [CI 2.3-9.3], p<0.0001), and previous hospitalization (OR 2.9 [CI 1.4-6], p=0.003) were identified as independent risk factors for COMA-UTI due to QREc.

Conclusion: In patients with one or more of the risk factors identified here, the empiric use of quinolones should be reconsidered.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Analysis of Variance
  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use*
  • Case-Control Studies
  • Community-Acquired Infections / drug therapy
  • Community-Acquired Infections / epidemiology*
  • Community-Acquired Infections / microbiology
  • Drug Resistance, Bacterial
  • Escherichia coli / drug effects*
  • Escherichia coli Infections / drug therapy
  • Escherichia coli Infections / epidemiology*
  • Escherichia coli Infections / microbiology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Quinolones / pharmacology
  • Quinolones / therapeutic use*
  • Risk Factors
  • Urinary Tract Infections / drug therapy
  • Urinary Tract Infections / epidemiology*
  • Urinary Tract Infections / microbiology


  • Anti-Bacterial Agents
  • Quinolones