Predictive factors for Enterococcus faecalis in complicated community-acquired urinary tract infections in older patients
Por:
Madrazo M, Esparcia A, Alberola J, Ferrer A, Eiros JM, Nogueira JM and Artero A
Publicada:
1 mar 2020
Ahead of Print:
1 dic 2019
Resumen:
Aim Risk factors for complicated community acquired Enterococcus faecalis urinary tract infection (UTI) in older patients are not well known. Methods We identified the predictive factors for E. faecalis on a cohort of 659 older patients admitted to hospital with complicated UTI. We also examined the adequacy of empirical antimicrobial therapy and outcomes in E. faecalis UTI. Multivariable logistic regression was used to identify predictors of E. faecalis UTI. Results A total of 87 (13.2%) patients had E. faecalis UTI; of these 63.2% were men, their mean age was 82.3 years and they had a great number of comorbidities. Severe sepsis or septic shock was present in 50.5%, and bacteremia was present in 26%. Indwelling urinary catheter and previous urinary instrumentation were risk factors for E. faecalis UTI by multivariate analysis (OR 2.05; 95% CI 1.15-3.65 and OR 2.16; 95% CI 1.08-4.34, respectively). Inadequate empirical antimicrobial therapy was higher in E. faecalis UTI than in UTI caused by Gram-negative microorganisms (66.6% vs 19%, P < 0.001). No significant differences in length of hospital stay or mortality were noted between E. faecalis and Gram-negative UTI. Conclusions In older patients admitted to hospital with complicated community-acquired UTI, E. faecalis should be considered for empirical treatment if the patient has a urinary catheter or previous urinary tract instrumentation in order to avoid inadequate empirical antibiotic therapy. Geriatr Gerontol Int 2019; center dot center dot: center dot center dot-center dot center dot.
Filiaciones:
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Department of Internal Medicine, University Hospital Dr. Peset, University of Valencia, Valencia, Spain
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Department of Internal Medicine, University Hospital Dr. Peset, University of Valencia, Valencia, Spain
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Department of Microbiology, University Hospital Dr. Peset, University of Valencia, Valencia, Spain
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Department of Microbiology, University Hospital Dr. Peset, University of Valencia, Valencia, Spain
Eiros JM:
Department of Microbiology and Parasitology, School of Medicine, University Hospital Rio Hortega, University of Valladolid, Valladolid, Spain
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Department of Microbiology, University Hospital Dr. Peset, University of Valencia, Valencia, Spain
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Department of Internal Medicine, University Hospital Dr. Peset, University of Valencia, Valencia, Spain
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