Pseudomonas aeruginosa urinary tract infections in hospitalized patients: Mortality and prognostic factors.
The aim of this study was to analyze the mortality and predictors of 30-day mortality among hospitalized patients with Pseudomonas aeruginosa urinary tract infection (PAUTI) and the impact of antibiotic treatment on survival.Patients admitted to our hospital with PAUTI or those diagnosed of PAUTI du...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2017-01-01
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| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC5446154?pdf=render |
| _version_ | 1818262704603791360 |
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| author | Jose Luis Lamas Ferreiro Judith Álvarez Otero Lucía González González Luis Novoa Lamazares Alexandra Arca Blanco Jose Ramón Bermúdez Sanjurjo Irene Rodríguez Conde María Fernández Soneira Javier de la Fuente Aguado |
| author_facet | Jose Luis Lamas Ferreiro Judith Álvarez Otero Lucía González González Luis Novoa Lamazares Alexandra Arca Blanco Jose Ramón Bermúdez Sanjurjo Irene Rodríguez Conde María Fernández Soneira Javier de la Fuente Aguado |
| author_sort | Jose Luis Lamas Ferreiro |
| collection | DOAJ |
| description | The aim of this study was to analyze the mortality and predictors of 30-day mortality among hospitalized patients with Pseudomonas aeruginosa urinary tract infection (PAUTI) and the impact of antibiotic treatment on survival.Patients admitted to our hospital with PAUTI or those diagnosed of PAUTI during hospitalization for other disease between September 2012 and September 2014 were included. Repeated episodes from the same patient were excluded. Database with demographic, clinical and laboratory ítems was created. Empirical and definitive antibiotic therapy, antimicrobial resistance and all-cause mortality at 30 and 90 days were included.62 patients were included, with a mean age of 75 years. 51% were male. Mortality was 17.7% at 30 days and 33.9% at 90 days. Factors associated with reduced survival at 30 days were chronic liver disease with portal hypertension (P<0,01), diabetes mellitus (P = 0,04) chronic renal failure (P = 0,02), severe sepsis or septic shock (P<0,01), Charlson index > 3 (P = 0.02) and inadequated definitive antibiotic treatment (P<0,01). Independent risk factors for mortality in multivariate analysis were advanced chronic liver disease (HR 77,4; P<0,01), diabetes mellitus (HR 3,6; P = 0,04), chronic renal failure (HR 4,1; P = 0,03) and inadequated definitive antimicrobial treatment (HR 6,8; P = 0,01).PAUTI are associated with high mortality in hospitalized patients, which increases significantly in those with severe comorbidity such as chronic renal failure, advanced liver disease or diabetes mellitus. Inadequated antibiotic treatment is associated with poor outcome, which remarks the importance of adjusting empirical antibiotic treatment based on the microbiological susceptibility results. |
| first_indexed | 2024-12-12T19:07:21Z |
| format | Article |
| id | doaj.art-fd4bcedc7a3f4ce5966b0f6d57fe2a24 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-12T19:07:21Z |
| publishDate | 2017-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-fd4bcedc7a3f4ce5966b0f6d57fe2a242022-12-22T00:14:56ZengPublic Library of Science (PLoS)PLoS ONE1932-62032017-01-01125e017817810.1371/journal.pone.0178178Pseudomonas aeruginosa urinary tract infections in hospitalized patients: Mortality and prognostic factors.Jose Luis Lamas FerreiroJudith Álvarez OteroLucía González GonzálezLuis Novoa LamazaresAlexandra Arca BlancoJose Ramón Bermúdez SanjurjoIrene Rodríguez CondeMaría Fernández SoneiraJavier de la Fuente AguadoThe aim of this study was to analyze the mortality and predictors of 30-day mortality among hospitalized patients with Pseudomonas aeruginosa urinary tract infection (PAUTI) and the impact of antibiotic treatment on survival.Patients admitted to our hospital with PAUTI or those diagnosed of PAUTI during hospitalization for other disease between September 2012 and September 2014 were included. Repeated episodes from the same patient were excluded. Database with demographic, clinical and laboratory ítems was created. Empirical and definitive antibiotic therapy, antimicrobial resistance and all-cause mortality at 30 and 90 days were included.62 patients were included, with a mean age of 75 years. 51% were male. Mortality was 17.7% at 30 days and 33.9% at 90 days. Factors associated with reduced survival at 30 days were chronic liver disease with portal hypertension (P<0,01), diabetes mellitus (P = 0,04) chronic renal failure (P = 0,02), severe sepsis or septic shock (P<0,01), Charlson index > 3 (P = 0.02) and inadequated definitive antibiotic treatment (P<0,01). Independent risk factors for mortality in multivariate analysis were advanced chronic liver disease (HR 77,4; P<0,01), diabetes mellitus (HR 3,6; P = 0,04), chronic renal failure (HR 4,1; P = 0,03) and inadequated definitive antimicrobial treatment (HR 6,8; P = 0,01).PAUTI are associated with high mortality in hospitalized patients, which increases significantly in those with severe comorbidity such as chronic renal failure, advanced liver disease or diabetes mellitus. Inadequated antibiotic treatment is associated with poor outcome, which remarks the importance of adjusting empirical antibiotic treatment based on the microbiological susceptibility results.http://europepmc.org/articles/PMC5446154?pdf=render |
| spellingShingle | Jose Luis Lamas Ferreiro Judith Álvarez Otero Lucía González González Luis Novoa Lamazares Alexandra Arca Blanco Jose Ramón Bermúdez Sanjurjo Irene Rodríguez Conde María Fernández Soneira Javier de la Fuente Aguado Pseudomonas aeruginosa urinary tract infections in hospitalized patients: Mortality and prognostic factors. PLoS ONE |
| title | Pseudomonas aeruginosa urinary tract infections in hospitalized patients: Mortality and prognostic factors. |
| title_full | Pseudomonas aeruginosa urinary tract infections in hospitalized patients: Mortality and prognostic factors. |
| title_fullStr | Pseudomonas aeruginosa urinary tract infections in hospitalized patients: Mortality and prognostic factors. |
| title_full_unstemmed | Pseudomonas aeruginosa urinary tract infections in hospitalized patients: Mortality and prognostic factors. |
| title_short | Pseudomonas aeruginosa urinary tract infections in hospitalized patients: Mortality and prognostic factors. |
| title_sort | pseudomonas aeruginosa urinary tract infections in hospitalized patients mortality and prognostic factors |
| url | http://europepmc.org/articles/PMC5446154?pdf=render |
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