Community-onsetPseudomonas aeruginosaurinary sepsis in elderly people: Predictive factors, adequacy of empirical therapy and outcomes
Por:
Esparcia A, Madrazo M, Alberola J, López-Cruz I, Eiros JM, Nogueira JM and Artero A
Publicada:
1 dic 2019
Ahead of Print:
1 oct 2019
Categoría:
Medicine (miscellaneous)
Resumen:
Purpose To know the predictive factors forPseudomonas aeruginosa(PA) urinary sepsis in hospitalised elderly patients coming from community, the adequacy of empirical antibiotic therapy and its outcomes. Methods Retrospective case-control study conducted between 2007 and 2017. Patients aged 65 years or older with PA urinary sepsis were included as cases. Three age-matched controls, with urinary sepsis caused by other microorganisms, were selected for each case. Predictors for PA urinary sepsis were determined by logistic regression analysis. Adequacy of empirical antibiotic therapy and outcomes were compared between both groups. Results A total of 332 patients, from which 83 were cases, were included. Predictive factors for PA urinary sepsis were as follows: male sex (OR 3.16, 95% CI 1.61-6.10;P < .001), urinary catheter (OR 3.25, 95% CI 1.73-6.11;P < .001) and healthcare-associated infection (OR 5.52, 95% CI 1.76 -17.29;P = .003). Inadequate empirical antimicrobial therapy (IEAT) and length of hospital stay were higher in PA group (42% vs 24%,P = .002; 7.45 +/- 4.36 days vs 6.43 +/- 3.82 days,P = .045, respectively), but mortality was not different (7.2% vs 8.8%,P = .648). Conclusions Pseudomonas aeruginosaurinary sepsis in elderly people was associated with male sex, urinary catheter and healthcare-associated infection. These infections had a higher rate of IEAT and a longer hospital stay than urinary sepsis caused by other microorganisms.
Filiaciones:
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Department of Internal Medicine. Hospital, Universitario Dr. Peset. València, Spain
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Department of Internal Medicine. Hospital, Universitario Dr. Peset. València, Spain
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Department of Microbiology. Hospital, Universitario Dr. Peset. Universitat de València, València, Spain
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Department of Internal Medicine. Hospital, Universitario Dr. Peset. València, Spain
Eiros JM:
Department of Microbiology and Parasitology. Hospital, Universitario Rio Hortega, School of Medicine, Universidad de Valladolid, Valladolid, Spain
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Department of Microbiology. Hospital, Universitario Dr. Peset. Universitat de València, València, Spain
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Department of Internal Medicine. Hospital, Universitario Dr. Peset. Universitat de València, València, Spain
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