Payal K Patel1, M Todd Greene2, Mary A M Rogers2, David Ratz3, Latoya Kuhn3, Jennifer Davis4, Sanjay Saint2. 1. Division of Infectious Diseases, VA Ann Arbor Healthcare System, Ann Arbor, MI; Division of Infectious Diseases, University of Michigan Health System, Ann Arbor, MI; Department of Veterans Affairs, University of Michigan Patient Safety Enhancement Program, Department of Veterans Affairs Hospital, Ann Arbor, MI. Electronic address: payalkp@umich.edu. 2. Department of Veterans Affairs, University of Michigan Patient Safety Enhancement Program, Department of Veterans Affairs Hospital, Ann Arbor, MI; Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI; Division of General Medicine, University of Michigan Health System, Ann Arbor, MI. 3. Department of Veterans Affairs, University of Michigan Patient Safety Enhancement Program, Department of Veterans Affairs Hospital, Ann Arbor, MI; Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI. 4. Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI.
Abstract
BACKGROUND: Hospital-acquired urinary tract-related bloodstream infections are rare but often lethal. Recent epidemiology of this condition among the United States veteran population is poorly described. METHODS: We conducted a retrospective review of hospital-acquired urinary tract-related bloodstream infections of adult inpatients admitted to 4 Veterans Affairs hospitals over 15 years. Electronic medical records were used to obtain clinical, demographic, and microbiologic information. Descriptive statistical analyses were conducted using chi-square tests of association. Test for trend was performed by genus of organism and for case fatality rate over time. RESULTS: While the most commonly isolated organisms were Staphylococcus spp. (36.5%), the incidence of infections caused by Escherichia and Klebsiella increased over time (P = .02 and P = .03, respectively). The overall in-hospital case fatality rate was 24.2% in 499 patients. The case fatality rate was 25.8% for patients with Staphylococcus infections and 20.7% for patients with enterococcal infections. CONCLUSIONS: Hospital-acquired urinary tract-related bloodstream infection is commonly due to Staphylococcus spp. and is related to the high fatality among United States veterans. Focused infection control efforts could decrease the incidence of this fatal infection. Published by Elsevier Inc.
BACKGROUND: Hospital-acquired urinary tract-related bloodstream infections are rare but often lethal. Recent epidemiology of this condition among the United States veteran population is poorly described. METHODS: We conducted a retrospective review of hospital-acquired urinary tract-related bloodstream infections of adult inpatients admitted to 4 Veterans Affairs hospitals over 15 years. Electronic medical records were used to obtain clinical, demographic, and microbiologic information. Descriptive statistical analyses were conducted using chi-square tests of association. Test for trend was performed by genus of organism and for case fatality rate over time. RESULTS: While the most commonly isolated organisms were Staphylococcus spp. (36.5%), the incidence of infections caused by Escherichia and Klebsiella increased over time (P = .02 and P = .03, respectively). The overall in-hospital case fatality rate was 24.2% in 499 patients. The case fatality rate was 25.8% for patients with Staphylococcus infections and 20.7% for patients with enterococcal infections. CONCLUSIONS: Hospital-acquired urinary tract-related bloodstream infection is commonly due to Staphylococcus spp. and is related to the high fatality among United States veterans. Focused infection control efforts could decrease the incidence of this fatal infection. Published by Elsevier Inc.
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