Prospective cohort study on hospitalised patients with suspected urinary tract infection and risk factors por multidrug resistance

Autor: Cristina Campo López, Miguel Salavert Lletí, José Miguel Sahuquillo-Arce, Rosario Alonso Estellés, Marta Dafne Cabañero-Navalon, Koen Jerusalem, Ana Isabel Renau Escrig, Iván Castro Hernández, Victor Garcia-Bustos, Victoria Morell Massó, Ignacio-Antonio Sigona-Giangreco
Jazyk: angličtina
Rok vydání: 2021
Předmět:
0301 basic medicine
Male
Antibiotics
Urinary incontinence
Diseases
0302 clinical medicine
Risk Factors
Drug Resistance
Multiple
Bacterial
Epidemiology
Outcome Assessment
Health Care
Medicine
030212 general & internal medicine
Prospective Studies
Prospective cohort study
Aged
80 and over
Multidisciplinary
Liver Diseases
Middle Aged
Anti-Bacterial Agents
Hospitalization
Urogenital diseases
Cardiovascular Diseases
Urinary Tract Infections
Infectious diseases
Female
medicine.symptom
Adult
medicine.medical_specialty
medicine.drug_class
Urinary system
Urology
Science
030106 microbiology
Microbiology
Article
Sepsis
03 medical and health sciences
Internal medicine
Humans
Renal Insufficiency
Chronic
Aged
business.industry
Length of Stay
medicine.disease
Comorbidity
Linear Models
Observational study
business
Zdroj: Scientific Reports, Vol 11, Iss 1, Pp 1-10 (2021)
Scientific Reports
ISSN: 2045-2322
Popis: Urinary tract infections (UTIs) are among the most common bacterial infections and a frequent cause for hospitalization in the elderly. The aim of our study was to analyse epidemiological, microbiological, therapeutic, and prognostic of elderly hospitalised patients with and to determine independent risk factors for multidrug resistance and its outcome implications. A single-centre observational prospective cohort analysis of 163 adult patients hospitalized for suspected symptomatic UTI in the Departments of Internal Medicine, Infectious Diseases and Short-Stay Medical Unit of a tertiary hospital was conducted. Most patients currently admitted to hospital for UTI are elderly and usually present high comorbidity and severe dependence. More than 55% met sepsis criteria but presented with atypical symptoms. Usual risk factors for multidrug resistant pathogens were frequent. Almost one out of five patients had been hospitalized in the 90 days prior to the current admission and over 40% of patients had been treated with antibiotic in the previous 90 days. Infection by MDR bacteria was independently associated with the previous stay in nursing homes or long-term care facilities (LTCF) (OR 5.8, 95% CI 1.17–29.00), permanent bladder catheter (OR 3.55, 95% CI 1.00–12.50) and urinary incontinence (OR 2.63, 95% CI 1.04–6.68). The degree of dependence and comorbidity, female sex, obesity, and bacteraemia were independent predictors of longer hospital stay. The epidemiology and presentation of UTIs requiring hospitalisation is changing over time. Attention should be paid to improve management of urinary incontinence, judicious catheterisation, and antibiotic therapy.
Databáze: OpenAIRE
Externí odkaz: