Alice Laudisio1, Felice Marinosci2, Davide Fontana3, Antonella Gemma4, Alessandro Zizzo2, Anna Coppola2, Leonardo Rodano2, Raffaele Antonelli Incalzi3,2. 1. Department of Geriatrics, Campus Bio-Medico University, Via Álvaro del Portillo, 200, 00128, Rome, Italy. lavoralice@gmail.com. 2. Fondazione San Raffaele-Cittadella della Carità, Piazzale Mons. G. Motolese, 1, 74123, Taranto, Italy. 3. Department of Geriatrics, Campus Bio-Medico University, Via Álvaro del Portillo, 200, 00128, Rome, Italy. 4. UOS Accesso e Presa in Carico Assistenziale, Azienda Sanitaria Locale Roma E, Borgo S. Spirito, 3, Rome, Italy.
Abstract
BACKGROUND: Urinary tract infections (UTIs), often sustained by polymicrobial flora (p-UTIs), are a common finding among nursing home patients, and associated with adverse outcomes and increased healthcare costs. P-UTIs have been extensively studied with regard to microbiological aspects. However, little is known about the characteristics of the host. AIMS: The aim of this study is to verify to which extent comorbidity characterizes elderly nursing home patients with p-UTIs. METHODS: We enrolled 299 patients with culture-positive UTI consecutively admitted to the nursing home of the "Fondazione San Raffaele Cittadella della Carità", Taranto, Italy. P-UTI was diagnosed when two uropathogens were simultaneously isolated. The burden of comorbidity was quantified using the Charlson comorbidity score index. Logistic regression analysis was used to assess the adjusted association of the variables of interest with the presence of p-UTI. RESULTS: P-UTIs were detected in 118/299 (39%) patients. According to logistic regression, the presence of p-UTIs was independently associated with the Charlson index (OR 1.70; 95% CI 1.06-2.72; P = .026). This association remained also after excluding participants without urinary catheter (OR 1.88; 95% CI 1.13-3.11; P = .015). DISCUSSION: The presence of P-UTIs is associated with the burden of comorbidity, but not with individual diseases. CONCLUSIONS: Older nursing home patients with comorbidity should be screened for the presence of p-UTIs; further studies are needed to evaluate the impact of early detection and treatment of p-UTIs on the development of comorbidity.
BACKGROUND:Urinary tract infections (UTIs), often sustained by polymicrobial flora (p-UTIs), are a common finding among nursing home patients, and associated with adverse outcomes and increased healthcare costs. P-UTIs have been extensively studied with regard to microbiological aspects. However, little is known about the characteristics of the host. AIMS: The aim of this study is to verify to which extent comorbidity characterizes elderly nursing home patients with p-UTIs. METHODS: We enrolled 299 patients with culture-positive UTI consecutively admitted to the nursing home of the "Fondazione San Raffaele Cittadella della Carità", Taranto, Italy. P-UTI was diagnosed when two uropathogens were simultaneously isolated. The burden of comorbidity was quantified using the Charlson comorbidity score index. Logistic regression analysis was used to assess the adjusted association of the variables of interest with the presence of p-UTI. RESULTS: P-UTIs were detected in 118/299 (39%) patients. According to logistic regression, the presence of p-UTIs was independently associated with the Charlson index (OR 1.70; 95% CI 1.06-2.72; P = .026). This association remained also after excluding participants without urinary catheter (OR 1.88; 95% CI 1.13-3.11; P = .015). DISCUSSION: The presence of P-UTIs is associated with the burden of comorbidity, but not with individual diseases. CONCLUSIONS: Older nursing home patients with comorbidity should be screened for the presence of p-UTIs; further studies are needed to evaluate the impact of early detection and treatment of p-UTIs on the development of comorbidity.
Authors: Ana López-de-Andrés; Romana Albaladejo-Vicente; Domingo Palacios-Ceña; David Carabantes-Alarcon; José Javier Zamorano-Leon; Javier de Miguel-Diez; Marta Lopez-Herranz; Rodrigo Jiménez-García Journal: Int J Environ Res Public Health Date: 2020-12-16 Impact factor: 3.390
Authors: William E Fondrie; Tao Liang; Benjamin L Oyler; Lisa M Leung; Robert K Ernst; Dudley K Strickland; David R Goodlett Journal: Sci Rep Date: 2018-10-26 Impact factor: 4.379