PMID- 37404256 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20230718 IS - 1178-6973 (Print) IS - 1178-6973 (Electronic) IS - 1178-6973 (Linking) VI - 16 DP - 2023 TI - Association Between Proton Pump Inhibitor Use and Extended-Spectrum Beta-Lactamase Urinary Tract Infection in Adults: A Retrospective Study. PG - 4251-4258 LID - 10.2147/IDR.S415096 [doi] AB - PURPOSE: To study the association between proton pump inhibitor (PPI) use and the risk of urinary tract infection (UTI) caused by extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL). PATIENTS AND METHODS: A retrospective cross-sectional study was conducted between October 2018 and September 2019. Adults with ESBL-UTIs were compared to adults with UTIs caused by gram-negative bacteria (GNB) and those with UTIs caused by miscellaneous organisms. The association between ESBL infection and PPI use was assessed. RESULTS: A total of 117 of 277 ESBL cases, 229 of 679 non-ESBL GNB controls, and 57 of 144 non-ESBL miscellaneous controls were exposed to PPIs within 3 months prior to admission. The univariate analysis indicated unadjusted odds ratio for PPI exposure with ESBL infection versus the GNB controls was 1.43 (95% CI 1.07-1.90, P = 0.015) while the odds ratio for PPI exposure with ESBL infection versus miscellaneous organisms was 1.10 (95% CI 0.73-1.67, P = 0.633) indicating positive association (PPI exposure increases risk of ESBL infection). Multivariate analysis revealed a positive association between ESBL infection and PPI use versus the GNB controls with an odds ratio of 1.74 (95% CI 0.91-3.31). While Esomeprazole was positively associated with ESBL infection, particularly compared with the miscellaneous group (adjusted OR 1.35, 95% CI 0.47-3.88), Lansoprazole was inversely associated (adjusted OR 0.48, 95% CI 0.18-1.24 and adjusted OR 0.40, 95% CI 0.11-1.41 for ESBL versus GNB controls and ESBL versus miscellaneous organisms, respectively). CONCLUSION: Exposure to PPIs in the preceding 3 months showed an association with increased risk of ESBL-UTI. While Esomeprazole showed a positive association, Lansoprazole had an inverse association for ESBL-UTI. Restricting the use of PPIs may be beneficial in the fight against antimicrobial resistance. CI - (c) 2023 Purayil et al. FAU - Purayil, Nishan Kunnummal AU - Purayil NK AUID- ORCID: 0000-0003-2601-5078 AD - General Internal Medicine Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar. AD - Clinical Department, College of Medicine-QU Health, Qatar University, Doha, Qatar. AD - Department of Clinical Medicine, Weill Cornell Medicine-Qatar, Doha, Qatar. FAU - Naushad, Vamanjore A AU - Naushad VA AUID- ORCID: 0000-0003-0751-1308 AD - General Internal Medicine Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar. AD - Clinical Department, College of Medicine-QU Health, Qatar University, Doha, Qatar. AD - Department of Clinical Medicine, Weill Cornell Medicine-Qatar, Doha, Qatar. FAU - Chandra, Prem AU - Chandra P AD - Medical Research Center, Hamad Medical Corporation, Doha, Qatar. FAU - Joseph, Prakash AU - Joseph P AD - General Internal Medicine Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar. AD - Clinical Department, College of Medicine-QU Health, Qatar University, Doha, Qatar. FAU - Khalil, Zahida AU - Khalil Z AD - General Internal Medicine Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar. AD - Clinical Department, College of Medicine-QU Health, Qatar University, Doha, Qatar. FAU - Zahid, Muhammad AU - Zahid M AD - General Internal Medicine Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar. AD - Department of Clinical Medicine, Weill Cornell Medicine-Qatar, Doha, Qatar. FAU - Wilson, Godwin AU - Wilson G AD - Department of Clinical Medicine, Weill Cornell Medicine-Qatar, Doha, Qatar. AD - Department of Microbiology, Hamad Medical Corporation, Doha, Qatar. FAU - Kayakkool, Muhammed Kunhi AU - Kayakkool MK AD - General Internal Medicine Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar. AD - Clinical Department, College of Medicine-QU Health, Qatar University, Doha, Qatar. AD - Department of Clinical Medicine, Weill Cornell Medicine-Qatar, Doha, Qatar. FAU - Ayari, Basma AU - Ayari B AD - General Internal Medicine Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar. AD - Department of Clinical Medicine, Weill Cornell Medicine-Qatar, Doha, Qatar. FAU - Chalihadan, Sajid AU - Chalihadan S AD - General Internal Medicine Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar. FAU - Elmagboul, Emad Bashier I AU - Elmagboul EBI AD - Department of Microbiology, Hamad Medical Corporation, Doha, Qatar. FAU - Doiphode, Sanjay H AU - Doiphode SH AD - Department of Clinical Medicine, Weill Cornell Medicine-Qatar, Doha, Qatar. AD - Department of Microbiology, Hamad Medical Corporation, Doha, Qatar. LA - eng PT - Journal Article DEP - 20230629 PL - New Zealand TA - Infect Drug Resist JT - Infection and drug resistance JID - 101550216 PMC - PMC10317521 OTO - NOTNLM OT - ESBL OT - PPI OT - extended-spectrum beta-lactamase OT - proton pump inhibitor OT - urinary tract infections COIS- The authors declare that they have no financial interest or other conflict of interest to declare in this study. EDAT- 2023/07/05 13:05 MHDA- 2023/07/05 13:06 PMCR- 2023/06/29 CRDT- 2023/07/05 10:34 PHST- 2023/04/12 00:00 [received] PHST- 2023/06/21 00:00 [accepted] PHST- 2023/07/05 13:06 [medline] PHST- 2023/07/05 13:05 [pubmed] PHST- 2023/07/05 10:34 [entrez] PHST- 2023/06/29 00:00 [pmc-release] AID - 415096 [pii] AID - 10.2147/IDR.S415096 [doi] PST - epublish SO - Infect Drug Resist. 2023 Jun 29;16:4251-4258. doi: 10.2147/IDR.S415096. eCollection 2023.