Abstract
Occurrence of urosepsis is not uncommon following urinary tract infections (UTI). However, there is a lack of evidence explaining the risk factors predisposing to urosepsis in patients with chronic kidney disease (CKD). This retrospective study was undertaken to evaluate the incidence and possible risk factors for urosepsis among patients hospitalized with UTI in a cohort of CKD patients. Patients were divided into the urosepsis group and the non-urosepsis group. Of 489 hospitalized patients with UTI, 70 (14.3%) acquired urosepsis. Stepwise multivariate logistic regression demonstrated that diabetes, urinary catheter and length of hospital stay (p < 0.001 for all) were significant independent predictive risk factors for urosepsis in CKD patients with UTI in addition to age, glomerular filtration rate, hydronephrosis, acute kidney injury and E. coli infection (p < 0.05 for all). Finally, Klebsiella spp. cases were associated with significantly higher odds for urosepsis than E. coli cases (OR: 3.5, 95% CI: 2.86–7.23, p < 0.001 vs. OR: 1.38, 95% CI: 1.19–3.69, p = 0.038). Diabetes, presence of an indwelling urinary catheter, length of hospitalization, and infection with Klebsiella spp were independent risk factors for urosepsis in CKD patients with UTI.
Highlights
Occurrence of urosepsis is not uncommon following urinary tract infections (UTI)
This study was undertaken to evaluate the incidence and possible risk factors for urosepsis among patients hospitalized with UTI in a cohort of chronic kidney disease (CKD) patients attending the nephrology clinic
receiver operating characteristic (ROC) curve analysis showed that presence of urinary catheter (AUC: 0.79, 95%confidence intervals (CIs): 0.70–0.82, p < 0.001), infection with Klebsiella spp (AUC: 0.74, 95%CI: 0.71–0.84, p < 0.001), and duration of hospitalisation (AUC: 0.68, 95%CI: 0.60–0.79, p < 0.001) could predict increased risk from urosepsis in CKD patients with UTI
Summary
There is a lack of evidence explaining the risk factors predisposing to urosepsis in patients with chronic kidney disease (CKD) This retrospective study was undertaken to evaluate the incidence and possible risk factors for urosepsis among patients hospitalized with UTI in a cohort of CKD patients. Stepwise multivariate logistic regression demonstrated that diabetes, urinary catheter and length of hospital stay (p < 0.001 for all) were significant independent predictive risk factors for urosepsis in CKD patients with UTI in addition to age, glomerular filtration rate, hydronephrosis, acute kidney injury and E. coli infection (p < 0.05 for all). Presence of an indwelling urinary catheter, length of hospitalization, and infection with Klebsiella spp were independent risk factors for urosepsis in CKD patients with UTI. This study was undertaken to evaluate the incidence and possible risk factors for urosepsis among patients hospitalized with UTI in a cohort of CKD patients attending the nephrology clinic
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