Persistent Extended-Spectrum β-Lactamase Urinary Tract Infection

摘要

To the Editor: Uncomplicated urinary tract infections (UTIs) in oth-erwise healthy adults are usually treat-ed empirically because the causative microbe is highly predictable: 80%–90% are caused by Escherichia coli. In addition, short courses of therapy (1 day or 3 days) are usually complet-ed before laboratory results become available. In the past decade, reports of community-acquired, extended-spectrum β-lactamase (ESBL)–pro-ducing E. coli isolates have increased worldwide, but they are still uncom-mon in the United States (1), where re-ported cases are generally associated with hospitals. An early report of true community-acquired ESBL-producing E. coli infections in the United States was published in 2007 (2). We report a case of community-acquired lower UTI caused by ESBL-producing and multidrug resistant E. coli in an oth-erwise healthy college-aged woman who had no hospital exposure. De-spite proper treatment, her infection persisted subclinically and symptoms recurred 2 months later