Effect of Bacteremia in Elderly Patients With Urinary Tract Infection
Por:
Artero A, Esparcia A, Eiros JM, Madrazo M, Alberola J and Nogueira JM
Publicada:
1 sep 2016
Ahead of Print:
7 jun 2016
Categoría:
Medicine (miscellaneous)
Resumen:
Introduction: The clinical effect of bacteremia on outcomes in urinary
tract infection (UTI) is still debated. This study aims to examine the
clinical effect of bacteremia in elderly patients with UTI requiring
hospital admission.
Methods: This retrospective observational study recorded the clinical
features, microbiology and outcomes in a Spanish cohort of patients aged
>= 65 years hospitalized for UTI in whom blood cultures were performed
in the emergency department. The primary outcome of the study was
in-hospital mortality.
Results: Of 333 patients, with a mean age of 81.6 years, 137 (41.1%) had
positive blood cultures. Escherichia coli, with 223 (66.9%) cases, was
the most common microorganism isolated. Independent risk factors of
bacteremia were temperature >38 degrees C, heart rate >90 bpm and
inversely both Enterococcus faecalis and Pseudomonas aeruginosa.
Bacteremia was not associated with the length of stay in hospital (6.96
+/- 3.50 days versus 7.33 +/- 5.54 days, P = 0.456). Mortality rate was
9.3% with no significant difference between bacteremic and nonbacteremic
cases (8.8% and 9.7%, respectively, P = 0.773). In-hospital mortality
analyzed by logistic regression was associated with McCabe index >2
(20.5% survival versus 66.7% death, adjusted odds ratio = 6.31, 95% CI:
2.71-14.67; P < 0.001) but not with bacteremia (41.4% survival versus
38.7% death, adjusted odds ratio = 0.99, 95% CI: 0.43-2.29; P = 0.992).
Conclusions: Our study suggests that the presence or absence of
bacteremia in elderly people with UTI requiring hospitalization does not
have an influence on outcomes such as in-hospital mortality or length of
stay.
Filiaciones:
:
Department of Internal Medicine, Hospital Universitario Dr. Peset, Universitat de València, Valencia, Spain.
:
Department of Internal Medicine, Hospital Universitario Dr. Peset, Universitat de València, Valencia, Spain
Eiros JM:
School of Medicine, Universidad de Valladolid, Valladolid, Spain
:
Department of Internal Medicine, Hospital Universitario Dr. Peset, Universitat de València, Valencia, Spain
:
Department of Microbiology, Hospital Universitario Dr. Peset, Universitat de València, Valencia, Spain
:
Department of Microbiology, Hospital Universitario Dr. Peset, Universitat de València, Valencia, Spain
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