Evaluation of host factors leading to the progression of urinary tract infections to urosepsis: a retrospective analysis from a tertiary care centre in Southern India

Abstract

Context: Urinary tract infections (UTIs) are one of the recurrently occurring disease caused by bacteria that poses a major public health concern globally. Among the well studied host factors that predispose to urosepsis are the anatomical risk factors of the urinary tract including stones, tumours and interventions involving the urogenital tract such as an indwelling catheter or transrectal prostate biopsy. Aims: To evaluate the host factors leading to the progression of UTI to urosepsis. Settings and design: Clinical and laboratory data available from patient records as per the inclusion criteria were analysed retrospectively by using a detailed proforma. Methods and materials: Patient records were screened using the ICD code provided from the Medical Records department. Data of patients with clinically confirmed UTI were retrieved and included in the study. Statistical analysis used: Patient data was analysed using SPSS software version 20. Categorical and continuous data were summarized as percentages and means ± SD or median (P25, P75) respectively. Univariate analysis was performed using the chi-square test or Fisher's exact test for categorical variables. Results: A total of 94 patient records were included in the study. Demographic data showed that majority (53.19%) of the patients (n = 94) were female individuals. The results of univariate analysis showed that gender, frequent UTI, diabetes mellitus, presence of an indwelling urinary catheter and hospitalization more than 6 months were significantly associated with urosepsis. In addition, results of multivariate analysis identified the independent risk factors for urosepsis associated with urinary tract pathogens. Conclusion: This study showed that there is significant association between risk factors that determine the outcome of UTI and its progression to urosepsis.