The Presence of Bacteremia Indicates Higher Inflammatory Response and Augments Disease Severity in Adult Patients with Urinary Tract Infections
Background: This study investigated the association between the presence of bacteremia and increase in the requirement for intensive care in adult patients with urinary tract infection (UTI). The study also analyzed the differences in clinical features between patients with versus without bacteremia...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-07-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/14/4223 |
| _version_ | 1797406003452444672 |
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| author | Chien-Chin Hsu Pei-Chen Lin Kuo-Tai Chen |
| author_facet | Chien-Chin Hsu Pei-Chen Lin Kuo-Tai Chen |
| author_sort | Chien-Chin Hsu |
| collection | DOAJ |
| description | Background: This study investigated the association between the presence of bacteremia and increase in the requirement for intensive care in adult patients with urinary tract infection (UTI). The study also analyzed the differences in clinical features between patients with versus without bacteremia. Methods: We conducted a retrospective screening of the medical records of adult patients admitted during a 4-month period at a single medical center. We excluded patients with concomitant infections and patients whose urine and blood samples were not collected in the emergency department (ED). The included patients were allocated to two groups—bacteremia and nonbacteremia groups—according to the blood culture results for samples collected in the ED. Results: The study cohort comprised 637 patients, including 158 (24.8%) patients in the bacteremia group and 479 (75.2%) patients in the nonbacteremia group. Compared with the patients in the nonbacteremia group, those in the bacteremia group satisfied more systemic inflammatory response syndrome (SIRS) criteria; they had a higher white cell count, C-reactive protein level, and sequential organ failure assessment (SOFA) scores; and had a greater requirement for intensive care (bacteremia vs. nonbacteremia; SIRS: 79.1% vs. 49.9%, <i>p</i> = 0.000; leukocytosis: 68.2% vs. 57.6%, <i>p</i> = 0.000; elevation of CRP: 96.2% vs. 78.6%, <i>p</i> = 0.000; SOFA: 39.2% vs. 23.2%, <i>p</i> = 0.000; requirement for intensive care: 13.9% vs. 4.4%, <i>p</i> = 0.000, respectively). According to the results of multivariate logistic regression, bacteremia and sepsis were independent factors associated with the requirement for intensive care. Conclusions: Bacteremia increased the requirement for intensive care in patients with UTI. Physicians can identify bacteremia using inflammatory markers, the SIRS criteria, and SOFA scores. |
| first_indexed | 2024-03-09T03:19:56Z |
| format | Article |
| id | doaj.art-f606f3198f6e4109ba8f391f8777db83 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T03:19:56Z |
| publishDate | 2022-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-f606f3198f6e4109ba8f391f8777db832023-12-03T15:14:00ZengMDPI AGJournal of Clinical Medicine2077-03832022-07-011114422310.3390/jcm11144223The Presence of Bacteremia Indicates Higher Inflammatory Response and Augments Disease Severity in Adult Patients with Urinary Tract InfectionsChien-Chin Hsu0Pei-Chen Lin1Kuo-Tai Chen2Emergency Department, Chi-Mei Medical Center, Tainan 710, TaiwanGraduate Institute of Biomedical Informatics, College of Medicine Science and Technology, Taipei Medical University, Taipei 106, TaiwanEmergency Department, Chi-Mei Medical Center, Tainan 710, TaiwanBackground: This study investigated the association between the presence of bacteremia and increase in the requirement for intensive care in adult patients with urinary tract infection (UTI). The study also analyzed the differences in clinical features between patients with versus without bacteremia. Methods: We conducted a retrospective screening of the medical records of adult patients admitted during a 4-month period at a single medical center. We excluded patients with concomitant infections and patients whose urine and blood samples were not collected in the emergency department (ED). The included patients were allocated to two groups—bacteremia and nonbacteremia groups—according to the blood culture results for samples collected in the ED. Results: The study cohort comprised 637 patients, including 158 (24.8%) patients in the bacteremia group and 479 (75.2%) patients in the nonbacteremia group. Compared with the patients in the nonbacteremia group, those in the bacteremia group satisfied more systemic inflammatory response syndrome (SIRS) criteria; they had a higher white cell count, C-reactive protein level, and sequential organ failure assessment (SOFA) scores; and had a greater requirement for intensive care (bacteremia vs. nonbacteremia; SIRS: 79.1% vs. 49.9%, <i>p</i> = 0.000; leukocytosis: 68.2% vs. 57.6%, <i>p</i> = 0.000; elevation of CRP: 96.2% vs. 78.6%, <i>p</i> = 0.000; SOFA: 39.2% vs. 23.2%, <i>p</i> = 0.000; requirement for intensive care: 13.9% vs. 4.4%, <i>p</i> = 0.000, respectively). According to the results of multivariate logistic regression, bacteremia and sepsis were independent factors associated with the requirement for intensive care. Conclusions: Bacteremia increased the requirement for intensive care in patients with UTI. Physicians can identify bacteremia using inflammatory markers, the SIRS criteria, and SOFA scores.https://www.mdpi.com/2077-0383/11/14/4223bacteremiaurinary tract infectionintensive caresepsissystemic inflammatory response syndrome (SIRS)sequential organ failure assessment (SOFA) |
| spellingShingle | Chien-Chin Hsu Pei-Chen Lin Kuo-Tai Chen The Presence of Bacteremia Indicates Higher Inflammatory Response and Augments Disease Severity in Adult Patients with Urinary Tract Infections Journal of Clinical Medicine bacteremia urinary tract infection intensive care sepsis systemic inflammatory response syndrome (SIRS) sequential organ failure assessment (SOFA) |
| title | The Presence of Bacteremia Indicates Higher Inflammatory Response and Augments Disease Severity in Adult Patients with Urinary Tract Infections |
| title_full | The Presence of Bacteremia Indicates Higher Inflammatory Response and Augments Disease Severity in Adult Patients with Urinary Tract Infections |
| title_fullStr | The Presence of Bacteremia Indicates Higher Inflammatory Response and Augments Disease Severity in Adult Patients with Urinary Tract Infections |
| title_full_unstemmed | The Presence of Bacteremia Indicates Higher Inflammatory Response and Augments Disease Severity in Adult Patients with Urinary Tract Infections |
| title_short | The Presence of Bacteremia Indicates Higher Inflammatory Response and Augments Disease Severity in Adult Patients with Urinary Tract Infections |
| title_sort | presence of bacteremia indicates higher inflammatory response and augments disease severity in adult patients with urinary tract infections |
| topic | bacteremia urinary tract infection intensive care sepsis systemic inflammatory response syndrome (SIRS) sequential organ failure assessment (SOFA) |
| url | https://www.mdpi.com/2077-0383/11/14/4223 |
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