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

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Victor Garcia-Bustos ◽  
Ana Isabel Renau Escrig ◽  
Cristina Campo López ◽  
Rosario Alonso Estellés ◽  
Koen Jerusalem ◽  
...  
Keyword(s):  
Risk Factors ◽  
Urinary Incontinence ◽  
Multidrug Resistance ◽  
Urinary Tract ◽  
Prospective Cohort ◽  
Bacterial Infections ◽  
Cohort Analysis ◽  
Term Care ◽  
Hospitalised Patients ◽  
Tract Infections

AbstractUrinary 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.

scholarly journals 1462. Derivation of a Prediction Model for Risk of Drug-Resistant Urinary Tract Infection

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S534-S534
Author(s):  
Sabeen Ali ◽  
Kimberly C Claeys
Keyword(s):  
Risk Factors ◽  
Urinary Tract ◽  
Long Term Care ◽  
Previous Literature ◽  
Antibiotic Prescribing ◽  
Drug Resistant ◽  
Term Care ◽  
Tract Infections ◽  
Scoring Tool

Abstract Background Urinary tract infections (UTIs) are among the most common indications for antibiotic therapy. As antibiotic resistance continues to grow, it is critical to identify those at higher risk for drug-resistant (DR) UTIs to guide empiric therapy, improve clinical outcomes, and limit costs of care. The aim of this study was to identify risk factors for DR UTI and develop a risk scoring tool which could aid in empiric antibiotic prescribing. Methods Single-center retrospective pilot study of adult patients treated for UTI from August 1, 2015 to August 31, 2016. Patients who had asymptomatic bacteriuria, were pregnant within 4 months of admission, or had improperly collected urine cultures were excluded. DR was defined as phenotypic resistance to at least 1 agent in 3 or more antibiotic classes commonly used to treat UTIs. Risk factors for DR UTI were derived from previously published literature and multivariable logistic regression of individual patient data (IPD). Adjusted odds ratios (aORs) were developed by combining ORs from previous literature and IPD. A scoring tool was derived from weight-proportional integer-adjusted coefficients of the predictive model aORs. Results Risk factors were derived from 9 previously published studies and adapted using IPD (N = 77) and included: long-term care (aOR = 4.31), prior hospitalization (aOR = 1.8), previous antibiotics (aOR = 4.33), advanced age (aOR = 1.12), urinary catheterization (aOR = 2.2), immune suppression (aOR = 1.6), and male sex (aOR = 2.56). Previous DR UTI was forced into the model (OR = 1.1). Baseline incidence of DR UTI was 28.7%. A risk score from 1 to 20 was developed and applied to IPD and demonstrated an area under the receiver operator curve (AUROC) of 0.625 (95% CI 0.484–0.767). Removing sex from the score produced an AUROC of 0.64 (95% CI 0.497–783). A sensitivity analysis applying the score to only urinary isolates that exhibited resistance to third-generation cephalosporins (13.8%) produced similar results. Conclusion Residence in long-term care and previous antibiotics were among the risk factors most closely associated with DR UTI. Considering cumulative risk scores may be useful in predicting DR UTI however the current study was hindered by a large degree of heterogeneity in previous literature. Disclosures All authors: No reported disclosures.

Symptoms, risk factors, diagnosis and treatment of urinary tract infections

2020 ◽  
pp. postgradmedj-2020-139090
Author(s):  
Rajanbir Kaur ◽  
Rajinder Kaur
Keyword(s):  
Risk Factors ◽  
Urinary Tract ◽  
Bacterial Infections ◽  
Diagnostic Methods ◽  
Microbial Infection ◽  
Improper Use ◽  
Life Threatening ◽  
Appropriate Therapy ◽  
Associated Risk Factors ◽  
Tract Infections

Urinary tract infection (UTI) is a common microbial infection found in all ages and sexes which involves inflammation of the urinary tract. These infections can range from simple bladder inflammation, that is, cystitis, to severe cases of uroseptic shock. UTI ranks as the number 1 infection that leads to a prescription of antibiotics after a doctor’s visit. These infections are sometimes distressing and even life threatening, and both males (12%) and females (40%) have at least one symptomatic UTI throughout their lives. Diagnostic failures in case of bacterial infections are the main contributing factor in improper use of antibiotics, delay in treatment and low survival rate in septic conditions. So, early diagnosis and appropriate therapy with antibiotics are the most significant requirements for preventing complicated UTI conditions such as urosepsis. This review article summarises the symptoms of the UTIs and the associated risk factors to it. The various conventional and recent diagnostic methods were also discussed in this review, along with treatment therapies with or without antibiotics.

Study of Multidrug Resistance Pattern among Escherichia coli isolated from patients with Urinary tract infection

2016 ◽  
Vol 9 (6) ◽  
pp. 157
Author(s):  
Soniya Goyal ◽  
Vikas Beniwal
Keyword(s):  
Escherichia Coli ◽  
Multidrug Resistance ◽  
Urinary Tract ◽  
Bacterial Infections ◽  
Multidrug Resistant ◽  
Resistance Pattern ◽  
Male Population ◽  
Antimicrobial Drugs ◽  
E Coli ◽  
Tract Infections

Objective: Urinary tract infections (UTIs) are some of the most common bacterial infections encountered in community and cause of significant morbidity and high medical cost. Escherichia coli is the most common pathogen belongs to Enterobacteriaceae family responsible for majority of UTI infections. Antimicrobial drugs have been routinely prescribed for empirical treatment of UTIs which has led to a dramatic increase in antibiotic resistance pattern of E. coli. The aim of present study was to analyse the multidrug resistance patterns (MDR) of E. coli isolated from UTI patients.Methods: A total of 80 urine samples collected from the patients suspected of having UTI attending Maharishi Markandeshwar Institute of Medical Sciences and Research (MMIMSR), Mullana, Ambala were cultured using standard microbiological techniques. Antibiotic susceptibility testing of E.coli was done by using minimum inhibitory concentration (MIC). MIC of tetracycline, doxycycline, azithromycin, erythromycin, ciprofloxacin, levofloxacin, ampicillin, amoxicillin and amikacin was done by agar dilution method.Results: Of the total 46 isolates contributing 33 females and 13 males were confirmed as E. coli. About 51.34% of the female patients belonged to the age group 21-40 yr and 53.84% of the male population belonged to 41-80 yr were found to be more susceptible to UTI infection. All isolates confirmed as E.coli were found to be multidrug resistant. 80% of the isolates exhibited MICs higher than 1000mg/L against β-lactams. 20% of the E. coli isolates exhibited MICs higher than 1000mg/L against ciprofloxacin, amikacin and erythromycin. 23% and 95% of E. coli isolates exhibited MICs less than 128 mg/L against doxycycline and levofloxacin respectively.Conclusion: The present study revealed the decreased susceptibility of the E.coli to all drugs. E. coli resistance profile to beta lactams, quinolones, macrolides, tetracyclines and aminoglycosides were also found to be quite high in this study emphasizing the need to educate public about appropriate use of antibiotics.NA

Risk Factors in Diabetes and Pregnant Women with Urinary Tract Infections Compared to Younger Aged Female.

2018 ◽  
Vol 1 (3) ◽  
pp. 26-38
Author(s):  
Abdulghani Mohamed Alsamarai ◽  
Shler Ali Khorshed
Keyword(s):  
Risk Factors ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Pregnant Women ◽  
Female Student ◽  
Mean Value ◽  
Infected Female ◽  
Significant Difference ◽  
Tract Infections

Background: Urinary tract infection is common with health impact in women and characterised by failure to treatment and recurrent episodes. Aim: This study was conducted to determine the risk factors for the development of urinary tract infection in diabetic and pregnant women in comparison to student female. Materials and methods: A prospective cross-sectional study conducted during the period from 1st of June 2015 to the end of January 2016. The population included in the study are 563 women, of them 425 were outpatients, and 138 were inpatients. Their age range between 18 and 80 years, with a mean age of 33.59±15.29 years. Urine samples collected and cultured on blood agar and MacConkey agar by spread plate technique. Bacterial colonies with different morphology were selected, purified and identified according to their biochemical characteristics using conventional standard methods. Results: In diabetic women, there were no significant difference in mean age and BMI values between culture positive and culture negative groups. However, pus cell mean scale was significantly higher [P=0.000] in women with urinary tract infection [1.76±1.25] than in those with negative culture [0.69±1.00]. In pregnant women, BMI mean value was significantly [P=0.013] lower in pregnant women with UTI [26.14] as compared to those without infection [26.99]. Pus cell scale mean value was significantly [P=0.000] higher in pregnant women with UTI [1.55] than women with negative UTI [0.85]. While there was no significant difference in mean age between UTI positive and negative pregnant women. In female student, there was a significant difference between UTI infected and non-infected in mean age [P=0.041] and pus cell scale [P=0.000]. However, BMI was not significantly different between infected and non-infected female student. Other risk factors association are variables in the 3 groups when analysed using X2, while AUC and OR show different trends of association between risk factors and UTI. Conclusion: BMI, pus cell scale, child number, delivery method, operation history and hospital setting were significantly associated with culture positivity in the 3 studied groups as determined by AUC. While OR confirmed association with pus sale scale in the 3 groups.

Infections and use of antibiotics in residents of long-term care facilities in Hungary

2014 ◽  
Vol 155 (23) ◽  
pp. 911-917 ◽  
Author(s):  
Rita Szabó ◽  
Karolina Böröcz
Keyword(s):  
Urinary Tract ◽  
Long Term Care ◽  
Soft Tissues ◽  
Good Practice ◽  
Antibiotic Use ◽  
Prevalence Survey ◽  
Term Care ◽  
Care Facilities ◽  
Tract Infections

Introduction: Healthcare associated infections and antimicrobial use are common among residents of long-term care facilities. Faced to the lack of standardized data, the European Centre for Disease Prevention and Control funded a project with the aim of estimating prevalence of infections and antibiotic use in European long-term care facilities. Aim: The aim of the authors was to present the results of the European survey which were obtained in Hungary. Method: In Hungary, 91 long-term care facilities with 11,823 residents participated in the point-prevalence survey in May, 2013. Results: The prevalence of infections was 2.1%. Skin and soft tissues infections were the most frequent (36%), followed by infections of the respiratory (30%) and urinary tract (21%). Antimicrobials were mostly prescribed for urinary tract infections (40.3%), respiratory tract infections (38.4%) and skin and soft tissue infections (13.2%). The most common antimicrobials (97.5%) belonged to the ATC J01 class of “antibacterials for systemic use”. Conclusions: The results emphasise the need for a national guideline and education for good practice in long-term care facilities. Orv. Hetil., 2014, 155(23), 911–917.

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