BACKGROUND: Risk factors for bacteremia in patients with hospital-acquired bacteriuria are largely unknown. Given the morbidity and costs associated with nosocomial bacteremia, determining risk factors could enhance the safety of hospitalized patients. METHODS: We conducted a case-control study within the Veterans Affairs Puget Sound Health Care System. A patient hospitalized between 1984 and 1999 from whom a urine culture and a blood culture grew the same organism > or =48 hours after admission was considered a case. Control patients were those with significant bacteriuria detected > or =48 hours after admission who did not have a positive blood culture. We used logistic regression to determine independent risk factors for bacteremia. RESULTS: There were 95 cases and 142 controls. Independent, statistically significant predictors of bacteremia included immunosuppressant therapy within 14 days of bacteriuria (odds ratio [OR], 8.13); history of malignancy (OR, 1.94); male sex (OR, 1.88); cigarette use in the past 5 years (OR, 1.26); number of hospital days before bacteriuria (OR, 1.03); and antibiotic use within 3 days of bacteriuria (OR, 0.76). Corticosteroid use within 7 days of bacteriuria predicted bacteremia in patients <70 years old (OR, 14.24). Similarly, patients <70 years old were more likely to develop bacteremia if they had diabetes mellitus (OR, 6.19). CONCLUSION: Delineating risk factors for nosocomial urinary tract-related bacteremia can help target appropriate preventive practices at the highest risk patients.
BACKGROUND: Risk factors for bacteremia in patients with hospital-acquired bacteriuria are largely unknown. Given the morbidity and costs associated with nosocomial bacteremia, determining risk factors could enhance the safety of hospitalized patients. METHODS: We conducted a case-control study within the Veterans Affairs Puget Sound Health Care System. A patient hospitalized between 1984 and 1999 from whom a urine culture and a blood culture grew the same organism > or =48 hours after admission was considered a case. Control patients were those with significant bacteriuria detected > or =48 hours after admission who did not have a positive blood culture. We used logistic regression to determine independent risk factors for bacteremia. RESULTS: There were 95 cases and 142 controls. Independent, statistically significant predictors of bacteremia included immunosuppressant therapy within 14 days of bacteriuria (odds ratio [OR], 8.13); history of malignancy (OR, 1.94); male sex (OR, 1.88); cigarette use in the past 5 years (OR, 1.26); number of hospital days before bacteriuria (OR, 1.03); and antibiotic use within 3 days of bacteriuria (OR, 0.76). Corticosteroid use within 7 days of bacteriuria predicted bacteremia in patients <70 years old (OR, 14.24). Similarly, patients <70 years old were more likely to develop bacteremia if they had diabetes mellitus (OR, 6.19). CONCLUSION: Delineating risk factors for nosocomial urinary tract-related bacteremia can help target appropriate preventive practices at the highest risk patients.
Authors: Robert Chang; M Todd Greene; Carol E Chenoweth; Latoya Kuhn; Emily Shuman; Mary A M Rogers; Sanjay Saint Journal: Infect Control Hosp Epidemiol Date: 2011-10-06 Impact factor: 3.254
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Authors: M Todd Greene; Sanjay Saint; David Ratz; Latoya Kuhn; Jennifer Davis; Payal K Patel; Mary A M Rogers Journal: Am J Infect Control Date: 2018-11-20 Impact factor: 2.918
Authors: Payal K Patel; M Todd Greene; Mary A M Rogers; David Ratz; Latoya Kuhn; Jennifer Davis; Sanjay Saint Journal: Am J Infect Control Date: 2018-03-13 Impact factor: 2.918
Authors: Mardi A Crane-Godreau; Matthew A Maccani; Susan K Eszterhas; Sandra L Warner; James A Jukosky; Steven Fiering Journal: Open Immunol J Date: 2009-01-01
Authors: M Todd Greene; Robert Chang; Latoya Kuhn; Mary A M Rogers; Carol E Chenoweth; Emily Shuman; Sanjay Saint Journal: Infect Control Hosp Epidemiol Date: 2012-08-23 Impact factor: 3.254