INTRODUCTION AND HYPOTHESIS: Complicated urinary tract infection (cUTI) is highly prevalent and costly for health systems. The impact of the indwelling urinary catheter on etiologic agents and clinical outcomes has been poorly studied in Latin America. METHODS: Cross-sectional study including patients with cUTI, with positive urine culture, treated at Hospital Universitario San Ignacio, Bogotá (Colombia) between 2017 and 2020. Clinical and microbiologic characteristics, treatments and outcomes are explored, comparing those with and without indwelling urinary catheter. RESULTS: Seven hundred thirty-five patients with non-catheter-associated cUTI (NC-cUTI) and 165 with catheter-associated cUTI (CAUTI) were included. CAUTI group had a higher proportion of recurrent UTI (18% vs 33.3%, p < 0.001), ICU requirement (2.7% vs 8.5%, p < 0.001), longer hospital stay (6 vs 10 days, p < 0.001) and > 30 days unplanned readmission rate (5.8% vs 10.3%, p < 0.001). In the same group, we found a higher frequency of Pseudomonas spp (2.6% vs 9.4%, p < 0.001), Enterococcus spp. (2.4% vs 3.3%, p = 0.016), Serratia marcescens (0.6% vs 3.3%, p < 0.001) and Citrobacter freundii (0.5% vs 5.7%, p < 0.001). It implied a higher number of patients treated with fourth-generation cephalosporins (1.4% vs 4.8%, p = 0.004), ertapenem (32.9% vs 41.8%, p = 0.027) and carbapenems associated with a second antibiotic (1.9% vs 8.5%, p < 0.001). CONCLUSIONS: Patients with CAUTI have a higher frequency of resistant germs, require greater use of resources and have worse clinical outcomes than patients who do not require such devices. Measures should be strengthened to minimize its use, in both the hospital and outpatient setting.
INTRODUCTION AND HYPOTHESIS: Complicated urinary tract infection (cUTI) is highly prevalent and costly for health systems. The impact of the indwelling urinary catheter on etiologic agents and clinical outcomes has been poorly studied in Latin America. METHODS: Cross-sectional study including patients with cUTI, with positive urine culture, treated at Hospital Universitario San Ignacio, Bogotá (Colombia) between 2017 and 2020. Clinical and microbiologic characteristics, treatments and outcomes are explored, comparing those with and without indwelling urinary catheter. RESULTS: Seven hundred thirty-five patients with non-catheter-associated cUTI (NC-cUTI) and 165 with catheter-associated cUTI (CAUTI) were included. CAUTI group had a higher proportion of recurrent UTI (18% vs 33.3%, p < 0.001), ICU requirement (2.7% vs 8.5%, p < 0.001), longer hospital stay (6 vs 10 days, p < 0.001) and > 30 days unplanned readmission rate (5.8% vs 10.3%, p < 0.001). In the same group, we found a higher frequency of Pseudomonas spp (2.6% vs 9.4%, p < 0.001), Enterococcus spp. (2.4% vs 3.3%, p = 0.016), Serratia marcescens (0.6% vs 3.3%, p < 0.001) and Citrobacter freundii (0.5% vs 5.7%, p < 0.001). It implied a higher number of patients treated with fourth-generation cephalosporins (1.4% vs 4.8%, p = 0.004), ertapenem (32.9% vs 41.8%, p = 0.027) and carbapenems associated with a second antibiotic (1.9% vs 8.5%, p < 0.001). CONCLUSIONS: Patients with CAUTI have a higher frequency of resistant germs, require greater use of resources and have worse clinical outcomes than patients who do not require such devices. Measures should be strengthened to minimize its use, in both the hospital and outpatient setting.
Authors: Victor M Blanco; Juan J Maya; Adriana Correa; Marcela Perenguez; Juan S Muñoz; Gabriel Motoa; Christian J Pallares; Fernando Rosso; Lorena Matta; Yamile Celis; Martha Garzon; María V Villegas Journal: Enferm Infecc Microbiol Clin Date: 2016-01-13 Impact factor: 1.731
Authors: Florian M E Wagenlehner; Truls E Bjerklund Johansen; Tommaso Cai; Bela Koves; Jennifer Kranz; Adrian Pilatz; Zafer Tandogdu Journal: Nat Rev Urol Date: 2020-08-25 Impact factor: 14.432