We analyzed the association between antibiotic resistance and recurrent urinary tract infection (rUTI) by Escherichia coli. Susceptibility levels to 14 antimicrobial agents and the presence of extended-spectrum β-lactamases (ESBL) were established using MicroScan. Incidences of multidrug resistant (MDR), extensively drug resistant (XDR), and ESBL-producer isolates as well as rUTIs were estimated. The time to recurrence was established adjusted for number of antibiotic-resistant families and MDR as predictors of interest, respectively. Overall, 8,553 urinary tract infection (UTI) cases related to E. coli, including 963 rITU, were analyzed with levels of resistance >30% in all cases, except for amikacin, nitrofurantoin, and carbapenems. The incidence of rUTI was of 11.3%, being 46.5%, 24.3%, and 42.5% for MDR, XDR, and ESBLs, respectively. Bivariate analysis showed that rUTI was associated with age, gender, resistance to specific antimicrobials, MDR, and XDR. The number of antibiotic families tested as resistant, MDR, XDR, gender, and age were associated with time to recurrence when adjusted for number of antibiotic families, and MDR, gender, and age were related when adjusted for MDR. High rates of antibiotic resistance to the usual antibiotics was observed in E. coli causing UTI, with female sex, age, and antibiotic resistance being risk factors for the development of rUTI.

中文翻译：

---

大肠埃希菌尿路感染的复发及其与抗生素耐药性的关系

我们分析了抗生素耐药性与大肠杆菌复发性尿路感染 (rUTI) 之间的关联。使用 MicroScan 确定了对 14 种抗菌剂的敏感性水平和超广谱 β-内酰胺酶 (ESBL) 的存在。估计了多重耐药 (MDR)、广泛耐药 (XDR) 和 ESBL 生产者分离株以及 rUTI 的发生率。复发时间的建立分别根据抗生素耐药家族的数量和作为感兴趣预测因子的 MDR 进行了调整。总体而言，8,553 例与大肠杆菌有关的尿路感染 (UTI) 病例除了阿米卡星、呋喃妥因和碳青霉烯类之外，所有情况下，包括 963 rITU 在内的 963 个 rITU 的耐药性水平均 > 30%。rUTI 的发生率为 11.3%，MDR、XDR 和 ESBLs 的发生率分别为 46.5%、24.3% 和 42.5%。双变量分析表明，rUTI 与年龄、性别、对特定抗菌药物的耐药性、MDR 和 XDR 相关。在调整抗生素家族数量后，测试为耐药、MDR、XDR、性别和年龄的抗生素家族数量与复发时间相关，在调整 MDR 后，MDR、性别和年龄与复发时间相关。在引起 UTI 的大肠杆菌中观察到对常用抗生素的抗生素耐药率很高，女性、年龄和抗生素耐药性是 rUTI 发展的危险因素。