Clinical impact of multidrug-resistant bacteria in older hospitalized patients with community-acquired urinary tract infection
Por:
Madrazo M, Esparcia A, López-Cruz I, Alberola J, Piles L, Viana A, Eiros JM and Artero A
Publicada:
7 dic 2021
Ahead of Print:
7 dic 2021
Categoría:
Infectious diseases
Resumen:
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.
Filiaciones:
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Internal Medicine Department, Doctor Peset University Hospital, Avda. Gaspar Aguilar, n 90, 46017, Valencia, Spain
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Internal Medicine Department, Doctor Peset University Hospital, Avda. Gaspar Aguilar, n 90, 46017, Valencia, Spain
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Internal Medicine Department, Doctor Peset University Hospital, Avda. Gaspar Aguilar, n 90, 46017, Valencia, Spain
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Microbiology Department, Doctor Peset University Hospital, Avda. Gaspar Aguilar, n 90, 46017, Valencia, Spain.
Universitat de València, Avda. Blasco Ibañez, n 17, 46010, Valencia, Spain.
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Internal Medicine Department, Doctor Peset University Hospital, Avda. Gaspar Aguilar, n 90, 46017, Valencia, Spain
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Internal Medicine Department, Doctor Peset University Hospital, Avda. Gaspar Aguilar, n 90, 46017, Valencia, Spain
Eiros JM:
Department of Microbiology and Parasitology, Rio Hortega University Hospital, University of Valladolid, C/ Dulzaina, 2, 47012, Valladolid, Spain
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Internal Medicine Department, Doctor Peset University Hospital, Avda. Gaspar Aguilar, n 90, 46017, Valencia, Spain
Universitat de València, Avda. Blasco Ibañez, n 17, 46010, Valencia, Spain
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