Trends in Incidence and Outcomes of Hospitalizations for Urinary Tract Infection among Older People in Spain (2001–2018)

Palacios‐Ceña, Domingo; Hernández‐Barrera, Valentín; Fernández‐de‐las‐Peñas, César; Miguel‐Díez, Javier de; Martínez-Hernández, D; Carabantes-Alarcón, David; Jiménez-García, Rodrigo; López‐de‐Andrés, Ana; López-Herránz, Marta

doi:10.3390/jcm10112332

Cited by 10 publications

(4 citation statements)

References 41 publications

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“…Se ha evidenciado una mayor frecuencia de urocultivos positivos en el sexo femenino, la edad avanzada y los niños menores de un año, el sondaje permanente, residir en zonas urbanas, últimos meses del año (coincidiendo con el periodo otoñal) y durante los años 2016 y 2017. A diferencia de lo obtenido por Palacios [ 7 ], que observan un incremento en los casos de BS en los últimos 18 años, en nuestro estudio se observa una disminución durante los años analizados, con un porcentaje de urocultivos positivos menor en 2020 respecto a los años anteriores, sobre todo en niños, posiblemente debido a que durante la pandemia por COVID-19 la asistencia al hospital por parte de los usuarios fue mucho menor por miedo al contagio, unido a que la actividad habitual tuvo que reducirse para atender a pacientes con dicha patología. Además, cabe destacar que a principio de 2018 se produjo un cambio organizativo en la gestión del hospital que derivó en una disminución de los urocultivos y, por tanto, en un descenso de los diagnósticos positivos de BS, por lo que, unido a lo comentado anteriormente sobre la pandemia, el descenso fue patente durante los cinco años.…”

Section: Discussionunclassified

“…A nivel local, los datos del estudio sobre Prevalencia de Infección Nosocomial realizado en 2019 reveló cifras del 12% de ITUs en pacientes ingresados en el Hospital Universitario Virgen de las Nieves de Granada entre el total de infecciones relacionadas con la asistencia sanitaria, siendo la prevalencia de pacientes con esta infección del 1,6% [ 6 ]. En España, la incidencia de ITUs en pacientes adultos hospitalizados ha experimentado un incremento desde el año 2001 en ambos sexos por igual, con un riesgo mayor de mortalidad en pacientes de mayor edad [ 7 ]. Más recientemente, algunos estudios apuntan a que la presencia de COVID-19 en pacientes hospitalizados puede incrementar la infección asociada a la asistencia sanitaria, y en concreto las ITUs, en pacientes sondados hasta un 43%, comparado con pacientes sin COVID-19 [ 8 ].…”

Section: Introductionunclassified

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Sociodemographic characteristics and risk factors associated to significative bacteriuria in a Spanish health area

Águila¹,

Solórzano-Puerto²,

Fernández-Sierra³

et al. 2022

Rev Esp Quimioter

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Objective. To determine the epidemiological characteristics of significative bacteriuria (SB) and their relationship with sociodemographic factors and to analyze risk factors in inpatients. Material and methods. Cross-sectional descriptive study carried out on urine culture samples received between 2016-2020 in the Microbiology laboratory, differentiating between minors and adults. The dependent variable was the presence of SB and the independent variables were age, sex, year, type of sample and source of the sample. In urine cultures of inpatients, risk factors were evaluated from the Minimum Basic Data Set. Results. A total of 68,587 valid records (96.3% of the total) were analyzed. 40.8% (95% CI: 40.4%-41.2%) of urine cultures in adults and 33.8% (95% CI: 32.9%-34.7%) in children were positive, with an incidence that ranged in adults between 18.2 cases/1,000 inhabitants in 2016 and 14.6 cases/1,000 inhabitants in 2020 and 21.1 and 8.4 cases/1,000 inhabitants respectively in minors. Positive urine cultures were more frequent in children from urban areas compared to rural areas (OR=1.37; p<0.01). In hospitalized adults, for each year of age the risk of SB increased by 2%, it was 36% higher in women, 18% higher in obese patients and 17% more frequent in patients with kidney disease, (p<0.01). No relationship was observed between SB and diagnosis of COVID-19. Conclusion. The sociodemographic characteristics of the population with SB in our health area are similar to those found in other geographical areas worldwide, observing a decreasing trend in incidence in the years studied. The frequency of SB in children is higher in urban areas

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Section: Discussionunclassified

Section: Introductionunclassified

Sociodemographic characteristics and risk factors associated to significative bacteriuria in a Spanish health area

Águila¹,

Solórzano-Puerto²,

Fernández-Sierra³

et al. 2022

Rev Esp Quimioter

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“…Urinary tract infection (UTI) is one of the most frequent causes of bacteremia and sepsis [ 6 , 7 ], and Enterobacteriaceae are the main causes of UTI. Extended-spectrum beta-lactamases (ESBL) are a resistance mechanism that are increasingly common among these bacteria.…”

Section: Introductionmentioning

confidence: 99%

Risk Factors and the Impact of Multidrug-Resistant Bacteria on Community-Acquired Urinary Sepsis

Madrazo,

López-Cruz,

Piles

et al. 2023

Microorganisms

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Risk factors for multidrug-resistant bacteria (MDRB) in nosocomial urinary tract infection (UTI) have been widely studied. However, these risk factors have not been analyzed in community-acquired urinary sepsis (US), nor have its outcomes been studied. The aim of our study is to determine risk factors for MDRB in community-acquired US and its influence on outcomes. Prospective observational study of patients with community-acquired US admitted to a university hospital. We compared epidemiological and clinical variables and outcomes of US due to MDRB and non-MDRB. Independent risk factors for MDRB were analyzed using logistic regression. A total of 193 patients were included, 33.7% of them with US due to MDRB. The median age of patients was 82 years. Hospital mortality was 17.6%, with no difference between the MDRB and non-MDRB groups. The length of hospital stay was 5 (4–8) days, with a non-significant tendency to longer hospital stays in the MDRB group (6 (4–10) vs. 5 (4–8) days, p = 0.051). Healthcare-associated US was found to be an independent risk factor for MDR bacteria by multivariate analysis. In conclusion, the impact of MDR bacteria on the outcomes of community-acquired urinary sepsis was mild. Healthcare-associated US was an independent risk factor for MDR bacteria.

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“…Urinary tract infections (UTI) are among the most common bacterial infections leading to clinic visits and can cause serious sequelae, such as renal damage and urosepsis [ 6 , 7 , 8 ]. In 2019, the global incident cases of UTI were 0.4 billion, an increase of 60.40% from 1990 [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Global and Regional Burden of Bacterial Antimicrobial Resistance in Urinary Tract Infections in 2019

Fan

et al. 2022

JCM

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Background: There are still no detailed data about the burden of bacterial antimicrobial resistance (AMR) in urinary tract infections (UTI). Concrete knowledge of global and regional bacterial AMR data is crucial for developing informed programs and policies to control bacterial AMR and for prudent use of antibiotics to optimize antibiotic therapy in patients with UTI. This study aimed to provide comprehensive global and regional estimates for the AMR burden of UTI in 2019. Methods: Data were obtained from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD), including death, disability-adjusted life-years (DALYs), year lived with disability (YLD), and years of life lost (YLL) for bacterial AMR in UTI for 7 GBD super-regions, 21 regions, 14 pathogens, 13 antibiotic classes, and 66 pathogen-antibiotic combinations in 2019. The estimates were based on two counterfactual scenarios: drug-susceptible infection and no infection. Results: Globally, there were 64.89 thousand deaths (95% uncertainty interval [UI]: 45.86–93.35) attributed to and 0.26 million deaths (95% UI: 0.18–0.36) associated with bacterial AMR in UTI in 2019. Among regions, the all-age death rates were higher in southern Latin America, tropical Latin America, and Europe and lower in sub-Saharan Africa. Escherichia coli and Klebsiella pneumoniae accounted for more than 50% of deaths attributable to and associated with AMR, and resistance was high among multiple types of antibiotic class, including fluoroquinolones, carbapenems, and third-generation cephalosporins. There were 2 pathogen-drug combinations that caused more than 6000 resistance-attributable deaths: third-generation cephalosporin-resistant Escherichia coli and fluoroquinolone-resistant Escherichia coli. Conclusions: AMR in UTI is an unignorable health problem, both for the management of urology disease and for global antibiotic resistance. Special tailored strategies, including enhanced surveillance and rational use of antibiotics, should be developed for different regions according to the region-specific pathogen-antibiotic situations and resources.

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Trends in Incidence and Outcomes of Hospitalizations for Urinary Tract Infection among Older People in Spain (2001–2018)

Cited by 10 publications

References 41 publications

Sociodemographic characteristics and risk factors associated to significative bacteriuria in a Spanish health area

Sociodemographic characteristics and risk factors associated to significative bacteriuria in a Spanish health area

Risk Factors and the Impact of Multidrug-Resistant Bacteria on Community-Acquired Urinary Sepsis

Global and Regional Burden of Bacterial Antimicrobial Resistance in Urinary Tract Infections in 2019

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