Clinical impact of multidrug-resistant bacteria in older hospitalized patients with community-acquired urinary tract infection.
BMC Infect Dis
; 21(1): 1232, 2021 Dec 07.
Article
em En
| MEDLINE
| ID: mdl-34876045
ABSTRACT
INTRODUCTION:
Previous 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.METHODS:
Cohort 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.RESULTS:
348 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.CONCLUSIONS:
The 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.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Infecções Urinárias
/
Infecção Hospitalar
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Infecções Comunitárias Adquiridas
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article