Clinical impact of multidrug-resistant bacteria in older hospitalized patients with community-acquired urinary tract infection

被引:18
|
作者
Madrazo, Manuel [1 ]
Esparcia, Ana [1 ]
Lopez-Cruz, Ian [1 ]
Alberola, Juan [2 ]
Piles, Laura [1 ,3 ]
Viana, Alba [1 ]
Eiros, Jose Maria [4 ]
Artero, Arturo [1 ,3 ]
机构
[1] Doctor Peset Univ Hosp, Dept Internal Med, Avda Gas Aguilar 90, Valencia 46017, Spain
[2] Doctor Peset Univ Hosp, Dept Microbiol, Avda Gaspar Aguilar 90, Valencia 46017, Spain
[3] Univ Valencia, Avda Blasco Ibanez 17, Valencia 46010, Spain
[4] Univ Valladolid, Rio Hortega Univ Hospi, Dept Microbiol & Parasitol, C Dulzaina,2, Valladolid 47012, Spain
关键词
Older adults; Risk factor; Inadequate empirical antimicrobial therapy; Outcomes; RISK-FACTORS; ANTIBIOTIC-RESISTANCE; EMERGENCY-DEPARTMENT; TREATMENT FAILURE; MANAGEMENT; MORTALITY; SEPSIS;
D O I
10.1186/s12879-021-06939-2
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
Introduction Previous studies have described some risk factors for multidrug-resistant (MDR) bacteria in urinary tract infection (UTI). However, the clinical impact of MDR bacteria on older hospitalized patients with community-acquired UTI has not been broadly analyzed. We conducted a study in older adults with community-acquired UTI in order to identify risk factors for MDR bacteria and to know their clinical impact. Methods Cohort prospective observational study of patients of 65 years or older, consecutively admitted to a university hospital, diagnosed with community-acquired UTI. We compared epidemiological and clinical variables and outcomes, from UTI due to MDR and non-MDR bacteria. Independent risk factors for MDR bacteria were analyzed using logistic regression. Results 348 patients were included, 41.4% of them with UTI due to MDR bacteria. Median age was 81 years. Hospital mortality was 8.6%, with no difference between the MDR and non-MDR bacteria groups. Median length of stay was 5 [4-8] days, with a longer stay in the MDR group (6 [4-8] vs. 5 [4-7] days, p = 0.029). Inadequate empirical antimicrobial therapy (IEAT) was 23.3%, with statistically significant differences between groups (33.3% vs. 16.2%, p < 0.001). Healthcare-associated UTI variables, in particular previous antimicrobial therapy and residence in a nursing home, were found to be independent risk factors for MDR bacteria. Conclusions The clinical impact of MDR bacteria was moderate. MDR bacteria cases had higher IEAT and longer hospital stay, although mortality was not higher. Previous antimicrobial therapy and residence in a nursing home were independent risk factors for MDR bacteria.
引用
收藏
页数:7
相关论文
共 50 条
  • [31] Hospitalization for community-acquired febrile urinary tract infection: validation and impact assessment of a clinical prediction rule
    Janneke E. Stalenhoef
    Willize E. van der Starre
    Albert M. Vollaard
    Ewout W. Steyerberg
    Nathalie M. Delfos
    Eliane M.S. Leyten
    Ted Koster
    Hans C. Ablij
    Jan W. van’t Wout
    Jaap T. van Dissel
    Cees van Nieuwkoop
    BMC Infectious Diseases, 17
  • [32] Cefazolin versus fluoroquinolones for the treatment of community-acquired urinary tract infections in hospitalized patients
    Uppala, Amulya
    King, Esther A.
    Patel, Dimple
    EUROPEAN JOURNAL OF CLINICAL MICROBIOLOGY & INFECTIOUS DISEASES, 2019, 38 (08) : 1533 - 1538
  • [33] Cefazolin versus fluoroquinolones for the treatment of community-acquired urinary tract infections in hospitalized patients
    Amulya Uppala
    Esther A. King
    Dimple Patel
    European Journal of Clinical Microbiology & Infectious Diseases, 2019, 38 : 1533 - 1538
  • [34] Hospitalization for community-acquired febrile urinary tract infection: validation and impact assessment of a clinical prediction rule
    Stalenhoef, Janneke E.
    van der Starre, Willize E.
    Vollaard, Albert M.
    Steyerberg, Ewout W.
    Delfos, Nathalie M.
    Leyten, Eliane M. S.
    Koster, Ted
    Ablij, Hans C.
    van't Wout, Jan W.
    van Dissel, Jaap T.
    van Nieuwkoop, Cees
    BMC INFECTIOUS DISEASES, 2017, 17
  • [35] Utility of PES score in predicting multidrug-resistant community-acquired pneumonia
    Dianne Ayuyao, Lea
    Ong-Dela Cruz, Bernice
    RESPIROLOGY, 2024, 29 : 242 - 242
  • [36] A clinical approach to multidrug-resistant urinary tract infection and subclinical bacteriuria in dogs and cats
    Johnstone, T.
    NEW ZEALAND VETERINARY JOURNAL, 2020, 68 (02) : 69 - 83
  • [37] The Risk Factors of Multidrug-Resistant Organisms in Hospitalized Patients with Community-Acquired Pneumonia in Dr. Soetomo Hospital Surabaya, Indonesia
    Soedarsono, Soedarsono
    Widyaningsih, Putu Dyah
    Mertaniasih, Ni Made
    ACTA MEDICA INDONESIANA, 2021, 53 (02) : 169 - 176
  • [38] PREDICTION OF MULTIDRUG-RESISTANT BACTERIA IN URINARY TRACT INFECTIONS IN THE EMERGENCY DEPARTMENT
    Ruiz-Ramos, Jesus
    Monje-Lopez, Alvaro Eloy
    Medina-Catalan, David
    Herrera-Mateo, Sergio
    Hernandez-Ontiveros, Hector
    Rivera-Martinez, Maria Alba
    Pereira-Batista, Celso Soares
    Puig-Campmany, Mireia
    JOURNAL OF EMERGENCY MEDICINE, 2023, 65 (01): : 1 - 6
  • [39] Multidrug Resistant Gram-Negative Bacteria in Community-Acquired Pneumonia
    Cilloniz, Catia
    Dominedo, Cristina
    Torres, Antoni
    CRITICAL CARE, 2019, 23 (1)
  • [40] Multidrug Resistant Gram-Negative Bacteria in Community-Acquired Pneumonia
    Catia Cillóniz
    Cristina Dominedò
    Antoni Torres
    Critical Care, 23