Abstract
IntroductionPrevious 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.MethodsCohort 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.Results348 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.ConclusionsThe 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.
Highlights
Previous studies have described some risk factors for multidrug-resistant (MDR) bacteria in urinary tract infection (UTI)
Extended-spectrum beta-lactamases (ESBL) are enzymes produced by Escherichia coli and other bacteria that are common etiologies in UTI [7]
We conducted a prospective study in older adults with community-acquired UTI admitted to hospital in order to identify risk factors for MDR bacteria and to know their clinical impact
Summary
Previous studies have described some risk factors for multidrug-resistant (MDR) bacteria in urinary tract infection (UTI). The clinical impact of MDR bacteria on older hospitalized patients with communityacquired 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. Previous studies have described some risk factors for MDR bacteria in UTI [13,14,15]. The clinical impact of MDR bacteria on older hospitalized patients with community-acquired UTI has not been broadly analyzed [16]. We conducted a prospective study in older adults with community-acquired UTI admitted to hospital in order to identify risk factors for MDR bacteria and to know their clinical impact
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have