Risk factors for severe sepsis in community-onset bacteraemic urinary tract infection: Impact of antimicrobial resistance in a large hospitalised cohort

Shaw, Evelyn; Benito, Natividad; Rodríguez-Baño, Jesús; Padilla, Belén; Pintado, Vicente; Calbo, Esther; Pallarés, MªAngeles; Gozalo, Mónica; Ruíz-Garbajosa, Patricia; Horcajada, Juan Pablo; Gómez, Juana Carretero; Cercenado, Emilia; Bunshow, E.; Sánchez‐Carrillo, Carlos; Xercavins, Mariona; Riera, Montserrat; Mirelis, Beatriz; Gamallo, R.; Martínez, Luis Martínez; Fariñas, María Carmen; Cueto, Marina de; Pascual, A

doi:10.1016/j.jinf.2014.09.011

Cited by 21 publications

(19 citation statements)

References 27 publications

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“…In accordance with previous studies, we were unable to find differences in the frequency of severe sepsis or septic shock between CA-FUTI and HCA-FUTI [20]. Interestingly, more than a quarter of these patients had a urethral lithiasis that required drainage.…”

Section: Discussionsupporting

confidence: 89%

Differential characteristics of healthcare-associated compared to community-acquired febrile urinary tract infections in males

Smithson

Ramos

Bastida

et al. 2015

Eur J Clin Microbiol Infect Dis

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The objective of this study was to analyse the characteristics of healthcare-associated febrile urinary tract infection (HCA-FUTI) compared to community-acquired FUTI (CA-FUTI) in men. An ambispective cross-sectional study in which we recorded clinical and microbiology data and outcomes from males with FUTI attended in the Emergency Department was carried out. A total of 479 males with FUTI, 162 (33.8%) HCA-FUTI and 317 (66.2%) CA-FUTI, were included. HCA-FUTI patients were older (p < 0.001), had higher Charlson scores (p < 0.001) and received previous antimicrobial treatment more frequently (p < 0.001) compared to CA-FUTI patients. HCA-FUTI was less likely caused by Escherichia coli (p < 0.001) and more frequently by Klebsiella spp. (p = 0.02), Enterobacter spp. (p < 0.001) and Pseudomonas aeruginosa (p < 0.001). Resistance to ceftriaxone (p = 0.006), gentamicin (p < 0.001), quinolones (p < 0.001), co-trimoxazole (p = 0.001) and fosfomycin (p = 0.009) was higher among E. coli strains isolated from males with HCA-FUTI and so was the prevalence of extended-spectrum beta-lactamase and AmpC E. coli and Klebsiella spp.-producing strains (p = 0.012). Inadequate antimicrobial treatment and all-cause in-hospital mortality was associated with HCA-FUTI (p < 0.001 and p = 0.004, respectively). Independent factors for mortality were severe sepsis or septic shock [odds ratio (OR) 29; 95% confidence interval (CI): 3.9-214] and cirrhosis (OR 23.7; 95% CI: 1.6-350.6). Male patients with HCA-FUTI have different clinical characteristics, outcomes and microbiological features compared to CA-FUTI patients. Previous contact with the healthcare system has to be taken into consideration when deciding the optimal antimicrobial treatment in males with FUTI.

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Section: Discussionsupporting

confidence: 89%

Differential characteristics of healthcare-associated compared to community-acquired febrile urinary tract infections in males

Smithson

Ramos

Bastida

et al. 2015

Eur J Clin Microbiol Infect Dis

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“…In a Spanish cohort of community-onset bacteraemic UTIs from eight tertiary hospitals, risk factors associated with severe sepsis were fatal underlying disease, history of urinary obstruction and indwelling urinary catheters (11). In multivariate logistic regression analysis, urinary catheterisation remained a significant risk factor for patients without fatal underlying disease.…”

Section: Discussionmentioning

confidence: 97%

Does the presence of a urinary catheter predict severe sepsis in a bacteraemic cohort?

Melzer

Welch

2017

Journal of Hospital Infection

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“…Bacteramia is not uncommon in UTI, both in community and hospital settings and in all age groupsadults, elderly and neonates; but the burden varied widely in different studies. [11][12][13] Generally, outcome of UTI complicated by bacteramia is worse than those without. 14 In the present study, we found nearly 7% of our type 2 diabetic subjects diagnosed with UTI had concomitant bacteramia.…”

Section: Discussionmentioning

confidence: 99%

Urinary Tract Infection due to Extended-spectrum Beta-lactamase Producing Organisms is a Risk Factor for Bacteraemia Among Patients with Type 2 Diabetes Mellitus

et al. 2019

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Introduction: Urinary tract infection (UTI) is common among patients with diabetes mellitus and the aetiological agents are often extended-spectrum beta-lactamase (ESBL) producing bacteria. Diabetic patients with UTI are sometimes complicated by bacteraemia. This study was designed to evaluate whether UTI due to ESBL-positive organisms is a risk factor for bacteraemia among patients with type 2 diabetes mellitus. Methods: This was a cross-sectional analytical study, done in BIRDEM General Hospital, Dhaka, Bangladesh from January to April 2016. Adult (e”18 years) type 2 diabetic subjects of either sex with culture proven UTI were included in this study. All study participants were subjected to undergo blood cultures as well. ESBL-positivity of the infective organisms for UTI was evaluated as possible risk factor for bacteraemia. Results: Total patients were 145 including 119 (82%) females. Eshcerichia coli (112, 77.2%) was the most common aetiological agents followed by Klebsiella pneumoniae (28, 19.3%). In 54 (37.2%) patients UTI was due to ESBL-positive organisms. Ten (6.9%) patients were complicated by bacteraemia [7 (7/ 54, 13%) among patients with UTI due to ESBL-positive organisms and 3 (3/91, 3.3%) among patients with UTI due to non-ESBL organisms]. UTI due to ESBL-positive organisms appeared as a significant risk factor for bacteraemia (OR 4.37, 95% CI 1.08-17.38, p 0.03). Conclusion: Nearly two-fifths of UTI cases were due to ESBL-positive organisms in this study. ESBLpositivity of the causative organisms was a significant risk factor for bacteraemia among type 2 diabetic subjects. Bangladesh J Medicine Jan 2020; 31(1) : 9-12

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Risk factors for severe sepsis in community-onset bacteraemic urinary tract infection: Impact of antimicrobial resistance in a large hospitalised cohort

Cited by 21 publications

References 27 publications

Differential characteristics of healthcare-associated compared to community-acquired febrile urinary tract infections in males

Differential characteristics of healthcare-associated compared to community-acquired febrile urinary tract infections in males

Does the presence of a urinary catheter predict severe sepsis in a bacteraemic cohort?

Urinary Tract Infection due to Extended-spectrum Beta-lactamase Producing Organisms is a Risk Factor for Bacteraemia Among Patients with Type 2 Diabetes Mellitus

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