Predictive factors for early clinical response in community-onset Escherichia coli urinary tract infection and effects of initial antibiotic treatment on early clinical response

Table 1 Characteristics of patients with community-onset urinary tract infection caused by Escherichia coli

	Patients with an early clinical response (n = 338)	Patients without an early clinical response (n = 173)	P value
Age, mean (yr)	63.3 ± 18.3	66.19 ± 15.4	0.061
Male patients (%)	33 (9.8)	23 (13.3)	0.227
Mortality (%)	0	6 (3.5)	0.001
Comirbidities (%)
Diabetes mellitus	108 (31.9)	63 (36.4)	0.312
Chronic kidney disease	25 (7.4)	11 (6.3)	0.664
Type of residence before hospital admission; Community (%)	269 (79.6)	121 (69.9)	0.021
Length of hospital stay (d)	6.8 ± 3.4	11.1 ± 6.0	< 0.001
Time to defervescence (h)	36.9 ± 18.0	100.5 ± 42.3	< 0.001
Infection presentation (%)
Initial septic shock1	69 (20.4)	49 (28.3)	0.047
Concurrent bacteremia	141 (41.7)	89 (51.4)	0.039
Acute renal failure2	29 (8.6)	23 (13.4)	0.121
Renal and perirenal abscesses	22 (6.5)	12 (6.9)	0.527
Complicated UTI (%)	99 (29.3)	56 (32.4)	0.347
ESBL producing E. coli (%)	69 (20.4)	25 (14.5)	0.117
Initial appropriate antibiotic therapy (%)	283 (83.7)	116 (67.0)	0.002
Initial broad-spectrum antibiotic therapy (%)	55 (16.3)	57 (32.9)	< 0.001
Improper use of broad-spectrum antimicrobials (%)	46 (13.6)	57 (32.9)	< 0.001
Laboratory features
White blood cells (per microliter of blood)	13480 ± 6350	13180 ± 7380	0.637
Platelet (per microliter of blood)	197850 ± 89250	175950 ± 65510	0.005
C-reactive protein (mg/L)	131.0 ± 81.3	146.9 ± 100	0.072
Albumin (g/dL)	3.62 ± 1.1	3.48 ± 0.5	0.096

¹Septic shock was defined as sepsis with hypotension (systolic blood pressure less than 90 mmHg or 40 mmHg less than the patient’s baseline blood pressure) for at least 1 h despite adequate fluid resuscitation.

²Acute renal failure was defined as an increase in the serum creatinine levels by more than 300% than the baseline values or serum creatinine ≥ 4.0 mg/L with an acute increase of at least 0.5 mg/dL. UTI: Urinary tract infections; ESBL: Extended-spectrum β-lactamase; E. coli: Escherichia coli.

Table 2 Identification of predictive factors of early clinical response in using multiple logistic regression analysis

Predictive factors of early clinical response	OR	95%CI	P value
Appropriate initial antibiotic therapy	2.449	1.294-4.637	0.006
Residence in a healthcare-associated facility before hospital admission	0.562	0.331-0.954	0.033
Initial septic shock	0.701	0.398-1.233	0.218
Concurrent bacteremia	0.730	0.459-1.162	0.185
Complications due to acute renal injury	0.920	0.426-1.986	0.831
ESBL-producing E. coli	2.112	1.020-4.374	0.044
Improper use of broad-spectrum antibiotic therapy	0.411	0.220-0.765	0.006
Initial broad-spectrum antibiotic therapy	0.614	0.330-1.141	0.123

ESBL: Extended-spectrum β-lactamase; E. coli: Escherichia coli.