Predictors of extended-spectrum <i>β</i>-lactamase-producing uropathogens in gram-negative Enterobacteriaceae urinary tract infections

Bae, Kaeun; Jeong, Tae Oh; Kim, So Eun; Yoon, Jae Chol

J Korean Soc Emerg Med > Volume 37(4); 2026 > Article

Original Article

Journal of The Korean Society of Emergency Medicine 2026;37(4): 203-210.

그람음성 장내세균 요로감염에서 광범위 베타락탐 분해 효소 생성 균주의 예측인자

배가은¹

, 정태오²

, 김소은²

, 윤재철^2,3

¹전북대학교병원 응급의학과
²전북대학교 의과대학 응급의학교실
³전북대학교병원 의생명연구원

Predictors of extended-spectrum β-lactamase-producing uropathogens in gram-negative Enterobacteriaceae urinary tract infections

¹Department of Emergency Medicine, Jeonbuk National University Hospital, Jeonju, Korea
²Department of Emergency Medicine, Jeonbuk National University Medical School, Jeonju, Korea
³Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Korea

Correspondence

Jae Chol Yoon ,Tel: 063-250-1075, Fax: 063-250-1075, Email: jcyoon75@jbnu.ac.kr,

Received: February 18, 2026; Revised: February 22, 2026 Accepted: February 22, 2026. Published online: August 31, 2026.

ABSTRACT

Objective:
The prevalence of urinary tract infections (UTIs) caused by extended-spectrum β-lactamase (ESBL)-producing gram-negative Enterobacteriaceae has been increasing worldwide. This study aimed to identify clinical predictors of ESBL-producing uropathogens in patients with UTI.
Methods:
A total of 120 hospitalized patients diagnosed with UTI and urine culture positive for Escherichia coli and Klebsiella pneumoniae were included. Univariate analysis was performed with baseline characteristics (age, sex, underlying diseases, risk factors, vital signs, National Early Warning Score), laboratory data, computed tomography findings, antibiotic susceptibility, and clinical outcomes. A binary logistic regression analysis was conducted to identify clinical predictors of ESBL-producing uropathogens.
Results:
In our patients, the prevalence of ESBL-producing uropathogens was 47.5%. Independent predictors of ESBLproducing infection included a history of cerebrovascular disease (adjusted odds ratio [AOR], 3.794; 95% confidence interval [CI], 1.106-13.019), hospitalization in the previous 3 months (AOR, 4.263; 95% CI, 1.700-10.688), prior infection with ESBL-producing pathogen (AOR, 4.893; 95% CI, 1.143-20.938), and negative nitrite result on urinalysis (AOR, 2.883; 95% CI, 1.189-6.993).
Conclusion:
The prevalence of UTIs caused by ESBL-producing uropathogens was high in our study. ESBL infection should be suspected in patients with risk factors such as a history of cerebrovascular disease, recent hospitalization, prior ESBL infection, and negative nitrite on urine analysis.

Key words: Extended-spectrum beta-lactamase; Enterobacteriaceae; Urinary tract infections