Clinical impact of multidrug-resistant bacteria in older hospitalized patients with community-acquired urinary tract infection
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...
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| Format: | Article |
| Language: | English |
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BMC
2021-12-01
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| Series: | BMC Infectious Diseases |
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| Online Access: | https://doi.org/10.1186/s12879-021-06939-2 |
| _version_ | 1818701160910946304 |
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| author | Manuel Madrazo Ana Esparcia Ian López-Cruz Juan Alberola Laura Piles Alba Viana José María Eiros Arturo Artero |
| author_facet | Manuel Madrazo Ana Esparcia Ian López-Cruz Juan Alberola Laura Piles Alba Viana José María Eiros Arturo Artero |
| author_sort | Manuel Madrazo |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-17T15:16:26Z |
| format | Article |
| id | doaj.art-c847b586d9264e2597cb0ab3884aacc0 |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-12-17T15:16:26Z |
| publishDate | 2021-12-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-c847b586d9264e2597cb0ab3884aacc02022-12-21T21:43:31ZengBMCBMC Infectious Diseases1471-23342021-12-012111710.1186/s12879-021-06939-2Clinical impact of multidrug-resistant bacteria in older hospitalized patients with community-acquired urinary tract infectionManuel Madrazo0Ana Esparcia1Ian López-Cruz2Juan Alberola3Laura Piles4Alba Viana5José María Eiros6Arturo Artero7Internal Medicine Department, Doctor Peset University HospitalInternal Medicine Department, Doctor Peset University HospitalInternal Medicine Department, Doctor Peset University HospitalMicrobiology Department, Doctor Peset University HospitalInternal Medicine Department, Doctor Peset University HospitalInternal Medicine Department, Doctor Peset University HospitalDepartment of Microbiology and Parasitology, Rio Hortega University Hospital, University of ValladolidInternal Medicine Department, Doctor Peset University HospitalAbstract 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.https://doi.org/10.1186/s12879-021-06939-2Older adultsRisk factorInadequate empirical antimicrobial therapyOutcomes |
| spellingShingle | Manuel Madrazo Ana Esparcia Ian López-Cruz Juan Alberola Laura Piles Alba Viana José María Eiros Arturo Artero Clinical impact of multidrug-resistant bacteria in older hospitalized patients with community-acquired urinary tract infection BMC Infectious Diseases Older adults Risk factor Inadequate empirical antimicrobial therapy Outcomes |
| title | Clinical impact of multidrug-resistant bacteria in older hospitalized patients with community-acquired urinary tract infection |
| title_full | Clinical impact of multidrug-resistant bacteria in older hospitalized patients with community-acquired urinary tract infection |
| title_fullStr | Clinical impact of multidrug-resistant bacteria in older hospitalized patients with community-acquired urinary tract infection |
| title_full_unstemmed | Clinical impact of multidrug-resistant bacteria in older hospitalized patients with community-acquired urinary tract infection |
| title_short | Clinical impact of multidrug-resistant bacteria in older hospitalized patients with community-acquired urinary tract infection |
| title_sort | clinical impact of multidrug resistant bacteria in older hospitalized patients with community acquired urinary tract infection |
| topic | Older adults Risk factor Inadequate empirical antimicrobial therapy Outcomes |
| url | https://doi.org/10.1186/s12879-021-06939-2 |
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