Prospective cohort study on hospitalised patients with suspected urinary tract infection and risk factors por multidrug resistance

Abstract Urinary tract infections (UTIs) are among the most common bacterial infections and a frequent cause for hospitalization in the elderly. The aim of our study was to analyse epidemiological, microbiological, therapeutic, and prognostic of elderly hospitalised patients with and to determine in...

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Autores principales:	Victor Garcia-Bustos, Ana Isabel Renau Escrig, Cristina Campo López, Rosario Alonso Estellés, Koen Jerusalem, Marta Dafne Cabañero-Navalón, Victoria Morell Massó, Ignacio-Antonio Sigona-Giangreco, José Miguel Sahuquillo-Arce, Iván Castro Hernández, Miguel Salavert Lletí
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/a457b8ae5fd64d97a972240527943545
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spelling	oai:doaj.org-article:a457b8ae5fd64d97a9722405279435452021-12-02T17:52:42ZProspective cohort study on hospitalised patients with suspected urinary tract infection and risk factors por multidrug resistance10.1038/s41598-021-90949-22045-2322https://doaj.org/article/a457b8ae5fd64d97a9722405279435452021-06-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-90949-2https://doaj.org/toc/2045-2322Abstract Urinary tract infections (UTIs) are among the most common bacterial infections and a frequent cause for hospitalization in the elderly. The aim of our study was to analyse epidemiological, microbiological, therapeutic, and prognostic of elderly hospitalised patients with and to determine independent risk factors for multidrug resistance and its outcome implications. A single-centre observational prospective cohort analysis of 163 adult patients hospitalized for suspected symptomatic UTI in the Departments of Internal Medicine, Infectious Diseases and Short-Stay Medical Unit of a tertiary hospital was conducted. Most patients currently admitted to hospital for UTI are elderly and usually present high comorbidity and severe dependence. More than 55% met sepsis criteria but presented with atypical symptoms. Usual risk factors for multidrug resistant pathogens were frequent. Almost one out of five patients had been hospitalized in the 90 days prior to the current admission and over 40% of patients had been treated with antibiotic in the previous 90 days. Infection by MDR bacteria was independently associated with the previous stay in nursing homes or long-term care facilities (LTCF) (OR 5.8, 95% CI 1.17–29.00), permanent bladder catheter (OR 3.55, 95% CI 1.00–12.50) and urinary incontinence (OR 2.63, 95% CI 1.04–6.68). The degree of dependence and comorbidity, female sex, obesity, and bacteraemia were independent predictors of longer hospital stay. The epidemiology and presentation of UTIs requiring hospitalisation is changing over time. Attention should be paid to improve management of urinary incontinence, judicious catheterisation, and antibiotic therapy.Victor Garcia-BustosAna Isabel Renau EscrigCristina Campo LópezRosario Alonso EstellésKoen JerusalemMarta Dafne Cabañero-NavalónVictoria Morell MassóIgnacio-Antonio Sigona-GiangrecoJosé Miguel Sahuquillo-ArceIván Castro HernándezMiguel Salavert LletíNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Victor Garcia-Bustos Ana Isabel Renau Escrig Cristina Campo López Rosario Alonso Estellés Koen Jerusalem Marta Dafne Cabañero-Navalón Victoria Morell Massó Ignacio-Antonio Sigona-Giangreco José Miguel Sahuquillo-Arce Iván Castro Hernández Miguel Salavert Lletí Prospective cohort study on hospitalised patients with suspected urinary tract infection and risk factors por multidrug resistance
description	Abstract Urinary tract infections (UTIs) are among the most common bacterial infections and a frequent cause for hospitalization in the elderly. The aim of our study was to analyse epidemiological, microbiological, therapeutic, and prognostic of elderly hospitalised patients with and to determine independent risk factors for multidrug resistance and its outcome implications. A single-centre observational prospective cohort analysis of 163 adult patients hospitalized for suspected symptomatic UTI in the Departments of Internal Medicine, Infectious Diseases and Short-Stay Medical Unit of a tertiary hospital was conducted. Most patients currently admitted to hospital for UTI are elderly and usually present high comorbidity and severe dependence. More than 55% met sepsis criteria but presented with atypical symptoms. Usual risk factors for multidrug resistant pathogens were frequent. Almost one out of five patients had been hospitalized in the 90 days prior to the current admission and over 40% of patients had been treated with antibiotic in the previous 90 days. Infection by MDR bacteria was independently associated with the previous stay in nursing homes or long-term care facilities (LTCF) (OR 5.8, 95% CI 1.17–29.00), permanent bladder catheter (OR 3.55, 95% CI 1.00–12.50) and urinary incontinence (OR 2.63, 95% CI 1.04–6.68). The degree of dependence and comorbidity, female sex, obesity, and bacteraemia were independent predictors of longer hospital stay. The epidemiology and presentation of UTIs requiring hospitalisation is changing over time. Attention should be paid to improve management of urinary incontinence, judicious catheterisation, and antibiotic therapy.
format	article
author	Victor Garcia-Bustos Ana Isabel Renau Escrig Cristina Campo López Rosario Alonso Estellés Koen Jerusalem Marta Dafne Cabañero-Navalón Victoria Morell Massó Ignacio-Antonio Sigona-Giangreco José Miguel Sahuquillo-Arce Iván Castro Hernández Miguel Salavert Lletí
author_facet	Victor Garcia-Bustos Ana Isabel Renau Escrig Cristina Campo López Rosario Alonso Estellés Koen Jerusalem Marta Dafne Cabañero-Navalón Victoria Morell Massó Ignacio-Antonio Sigona-Giangreco José Miguel Sahuquillo-Arce Iván Castro Hernández Miguel Salavert Lletí
author_sort	Victor Garcia-Bustos
title	Prospective cohort study on hospitalised patients with suspected urinary tract infection and risk factors por multidrug resistance
title_short	Prospective cohort study on hospitalised patients with suspected urinary tract infection and risk factors por multidrug resistance
title_full	Prospective cohort study on hospitalised patients with suspected urinary tract infection and risk factors por multidrug resistance
title_fullStr	Prospective cohort study on hospitalised patients with suspected urinary tract infection and risk factors por multidrug resistance
title_full_unstemmed	Prospective cohort study on hospitalised patients with suspected urinary tract infection and risk factors por multidrug resistance
title_sort	prospective cohort study on hospitalised patients with suspected urinary tract infection and risk factors por multidrug resistance
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/a457b8ae5fd64d97a972240527943545
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Prospective cohort study on hospitalised patients with suspected urinary tract infection and risk factors por multidrug resistance

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