Factors associated with the recurrence of acute pyelonephritis caused by extended-spectrum β-lactamase-producing Escherichia coli: the importance of infectious disease consultation.

To investigate factors for the recurrence of acute pyelonephritis (APN) caused by extended-spectrum β-lactamase-producing Escherichia coli (ESBL-PE), a retrospective cohort study was performed at a tertiary-care hospital from 2014 through 2016. Among 135 patients who had recovered from APN caused by ESBL-PE, the 1-year cumulative recurrence rates of APN caused by any pathogen or by ESBL-PE specifically were 35.6% and 22.1%, respectively. In a multivariate analysis, infectious disease (ID) consultation was associated with decreased recurrence (95% confidence interval [CI] = 0.24-0.96, P = 0.038 for recurrence caused by any pathogen; and 95% CI = 0.15-0.84, P = 0.019 for recurrence caused by ESBL-PE). History of APN within 1 year was a risk factor for recurrent APN caused by any pathogen (P = 0.011). Microbiological cure was a preventive factor for recurrent APN caused by ESBL-PE (P = 0.024). In conclusion, our data show that ID consultation protects against APN recurrence caused by ESBL-PE.