Time Trends in Spain from 2001 to 2018 in the Incidence and Outcomes of Hospitalization for Urinary Tract Infections in Patients with Type 2 Diabetes Mellitus.

Ana López-De-Andrés,Javier De Miguel-Diez,Domingo Palacios-Ceña,David Carabantes-Alarcon,José Javier Zamorano-Leon,Rodrigo Jiménez-García,Romana Albaladejo-Vicente,Marta Lopez-Herranz

doi:10.3390/ijerph17249427

Abstract

We aim to examine the incidences, clinical characteristics, and in-hospital outcomes of type 2 diabetes (T2DM) patients hospitalized with urinary tract infections (UTIs) in Spain and to identify the factors associated with in-hospital mortality (IHM). A retrospective observational study was carried out with a sample that included all adult patients who were hospitalized for UTIs between 2001 and 2018 and collected in the Spanish National Health System Hospital Discharge Database. We identified 850,276 patients with UTIs (25.49% with T2DM). The incidence of UTIs increased in patients with and without diabetes from 290.76 and 74.79 cases per 100,000 inhabitants in the period from year 2001 to year 2003 to 568.45 and 144.0 in the period from 2016 to 2018, respectively (p < 0.001). Adjusted incidence of UTIs was higher in T2DM patients (incidence rate ratio (IRR) 4.36; 95% CI 4.35–4.39). The multivariable analysis showed a significant reduction in the IHM over time for men and women with T2DM. In T2DM, patients’ higher IHM was associated with older age, comorbidities, and Staphylococcus aureus isolation. Women with T2DM had a higher risk of dying than men. The risk of IHM with an episode of UTIs was independent of the presence of T2DM (odds ratio (OR) 0.97; 95% CI 0.91–1.01). We conclude that the incidence of UTIs was over four times higher in T2DM than nondiabetic patients and has increased over time.

Highlights

Urinary tract infections (UTIs) are the most common type of bacterial infections in the community and, at hospital settings, resulting in high rates of morbidity and high economic costs associated with its treatment [1]
In patients who had an admission for urinary tract infections (UTIs), there was a significant female predominance (59.1% in type 2 diabetes mellitus (T2DM) and 59.5% in the nondiabetes population)
Our study reveals that the incidence of UTIs was higher in T2DM patients than in those without this disease and increased over time in both groups of patients and in both sexes

Summary

Introduction

Urinary tract infections (UTIs) are the most common type of bacterial infections in the community and, at hospital settings, resulting in high rates of morbidity and high economic costs associated with its treatment [1]. Public Health 2020, 17, 9427; doi:10.3390/ijerph17249427 www.mdpi.com/journal/ijerph

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