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Purayil NK, Naushad VA, Chandra P, Joseph P, Khalil Z, Zahid M, Wilson G, Kayakkool MK, Ayari B, Chalihadan S, Elmagboul EBI, Doiphode SH. Association Between Proton Pump Inhibitor Use and Extended-Spectrum Beta-Lactamase Urinary Tract Infection in Adults: A Retrospective Study. Infect Drug Resist 2023; 16:4251-4258. [PMID: 37404256 PMCID: PMC10317521 DOI: 10.2147/idr.s415096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 06/21/2023] [Indexed: 07/06/2023] Open
Abstract
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.
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Affiliation(s)
- Nishan Kunnummal Purayil
- General Internal Medicine Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
- Clinical Department, College of Medicine-QU Health, Qatar University, Doha, Qatar
- Department of Clinical Medicine, Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Vamanjore A Naushad
- General Internal Medicine Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
- Clinical Department, College of Medicine-QU Health, Qatar University, Doha, Qatar
- Department of Clinical Medicine, Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Prem Chandra
- Medical Research Center, Hamad Medical Corporation, Doha, Qatar
| | - Prakash Joseph
- General Internal Medicine Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
- Clinical Department, College of Medicine-QU Health, Qatar University, Doha, Qatar
| | - Zahida Khalil
- General Internal Medicine Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
- Clinical Department, College of Medicine-QU Health, Qatar University, Doha, Qatar
| | - Muhammad Zahid
- General Internal Medicine Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
- Department of Clinical Medicine, Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Godwin Wilson
- Department of Clinical Medicine, Weill Cornell Medicine-Qatar, Doha, Qatar
- Department of Microbiology, Hamad Medical Corporation, Doha, Qatar
| | - Muhammed Kunhi Kayakkool
- General Internal Medicine Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
- Clinical Department, College of Medicine-QU Health, Qatar University, Doha, Qatar
- Department of Clinical Medicine, Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Basma Ayari
- General Internal Medicine Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
- Department of Clinical Medicine, Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Sajid Chalihadan
- General Internal Medicine Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
| | | | - Sanjay H Doiphode
- Department of Clinical Medicine, Weill Cornell Medicine-Qatar, Doha, Qatar
- Department of Microbiology, Hamad Medical Corporation, Doha, Qatar
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Kandalam PTS, Parampath AN, Farghaly HI, Salah SA, Kayakkool MK, Mathew JV, Radhakrishnan P, Al Badawi I, Farook S. An unusual presentation of filariasis in a nonendemic country. Qatar Med J 2016; 2015:17. [PMID: 26865993 PMCID: PMC4740354 DOI: 10.5339/qmj.2015.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Accepted: 12/23/2015] [Indexed: 11/16/2022] Open
Abstract
Introduction: Filariasis is an endemic disease with worldwide distribution in tropical and subtropical regions. It is uncommon in Qatar. The conventional diagnostic procedure is the demonstration of microfilaria in blood smears. Even with its high incidence, it is unusual to detect microfilaria in fine needle aspiration cytology (FNAC) smears. Although the ‘filarial dance sign’ is rarely documented, it remains a classical ultrasonographic sign in lymphatic filariasis. Case presentation: We present a case of a 38-year-old male patient with fever, chills, shortness of breath and a tender warm swelling on his right thigh. Ultrasound of the thigh lesion showed the classical filarial dance sign. Subsequently FNAC from the lesion documented microfilaria in spite of absent peripheral blood eosinophilia and microfilaria. The patient underwent an incision and drainage of the thigh lesion and was treated with ivermectin and diethylcarbamazine. He was subsequently admitted to the medical ward and discharged home after two weeks in a stable condition. Conclusion: This case report illustrates the importance of diagnostic tools like ultrasound and FNAC along with a high index of clinical suspicion while evaluating patients presenting with unusual signs and symptoms. We would like to highlight the rarity of filarial presentation in a nonendemic country like Qatar. This case is unique since microfilaria was demonstrated in the pus aspirated from the thigh abscess and showed the filarial dance sign by ultrasound along with involvement of the pleura and pericardium.
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Affiliation(s)
| | - Arif Nelliyulla Parampath
- Department of Radiology, Emergency Radiology Section, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Hanan Ibrahim Farghaly
- Department of Laboratory Medicine, Pathology Section, Hamad General Hospital, Doha, Qatar
| | - Salem Abo Salah
- Emergency Department Short Stay Unit, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Muhammed Kunhi Kayakkool
- Emergency Department Short Stay Unit, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Joe Varghese Mathew
- Emergency Department Short Stay Unit, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Pradeep Radhakrishnan
- Emergency Department Short Stay Unit, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Ibrahim Al Badawi
- Emergency Department Short Stay Unit, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Saleena Farook
- Department of Medicine, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
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