Antimicrobial resistance in urosepsis: outcomes from the multinational, multicenter global prevalence of infections in urology (GPIU) study 2003–2013

Tandoğdu, Zafer; Bartoletti, R.; Cai, Tommaso; Çek, Mete; Grabe, Magnus; Kulchavenya, Ekaterina; Köves, Béla; Menon, Vandana; Naber, Kurt G.; Перепанова, Т С; Tenke, Péter; Wullt, Björn; Johansen, Truls E. Bjerklund; Wagenlehner, Florian M. E.

doi:10.1007/s00345-015-1722-1

Cited by 78 publications

(67 citation statements)

References 23 publications

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“…11 Unfortunately, in 20-40 % of cases, uroseptic shock leads to death. 4 Urosepsis needs to be understood as a severe condition, especially in the cases involving immunocompromised hosts or urinary tract …”

Section: Discussionmentioning

confidence: 99%

Shock due to urosepsis: A multicentre study

Yamamichi

Shigemura

Kitagawa

et al. 2017

CUAJ

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Introduction: Urosepsis is a severe infection that can cause shock afterwards. The purpose of this study is to investigate the clinical and bacterial risk factors for shock in those cases with urosepsis caused by urinary tract infection in a multicentre study. Methods: Our study included 77 consecutive urosepsis cases from four hospitals. We examined factors such as patient characteristics, underlying disease, serum white blood cell (WBC) count, platelet count, C-reactive protein (CRP) level at the time of diagnosis of urosepsis, urinary tract occlusion, causative bacteria, and bacterial antibiotic susceptibilities. Statistical analyses were performed to assess the potential risk factors for shock during the clinical course of urosepsis by a multivariate analysis. Results: We had 38 male and 39 female patients aged 25-104 (median 73). Underlying diseases included cancers (n=22, 28.6 %) and diabetes mellitus (n=17, 22.1 %). Positive blood culture was seen in 74 cases; these involved 88 bacterial strains, of which Escherichia coli was the most common (34 strains, 38.6 %). There were 31 cases with shock (40.3 %) and multivariate analyses demonstrated that serum CRP was the only clinical risk factor for shock due to urosepsis. Conclusions: Our study demonstrated that serum CRP was a risk factor for shock during urosepsis in a multicentre analysis. Further prospective studies with a greater number of patients are needed to draw more definitive conclusions.

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Section: Discussionmentioning

confidence: 99%

Shock due to urosepsis: A multicentre study

Yamamichi

Shigemura

Kitagawa

et al. 2017

CUAJ

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“…In detail, 50% of sepsis cases originate from pneumonia, 24% from intraperitoneal infection and 5–7% from UTI . Urosepsis causes septic shock in 31% of all septic shock cases . Qiang et al .…”

Section: Introductionmentioning

confidence: 99%

Bacteremia complicating urinary tract infection by Pseudomonas aeruginosa: Mortality risk factors

Kitagawa

Shigemura

Yamamichi³

et al. 2018

Int J of Urology

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Objectives To examine the clinical risk factors for death within 30 days of diagnosis of Pseudomonas aeruginosa‐causing bacteremia after a urinary tract infection. Methods A total of 62 patients with Pseudomonas aeruginosa isolated from both urine and blood at the same episode from January 2009 to December 2016 were enrolled in the present study. We retrospectively investigated clinical risk factors for death by comparison between surviving patients and those who died within 30 days after diagnosis of P. aeruginosa bacteremia. The comparison for risk factors for bacteremia‐related death included 31 categories, such as age, laboratory data, underlying diseases, clinical history, history of surgery, care in the intensive care unit, P. aeruginosa susceptibility to the antibiotics used at the time of bacteremia diagnosis and consultation with urological department. Results The study included 48 men and 14 women aged 71.3 ± 10.4 years. Nine patients (14.5%) died of P. aeruginosa bacteremia. Statistical analysis showed that non‐survivors had significantly lower albumin levels than survivors (2.07 ± 0.62 vs 2.62 ± 0.65; P = 0.023). The non‐survivors had significantly higher rates of ventilator use, history of heart disease, septic shock and lower rates of consultation with urological departments after diagnosis (P < 0.05). Conclusions Patients with bacteremia complicating urinary infection by P. aeruginosa have a low death rate. Earlier intervention by urologists might improve patients’ outcome. Lower albumin levels, ventilator use, history of heart disease and septic shock are factors associated with higher mortality rate.

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“…2,3,15 The results of the present study should be read in the light of the continuing increase of resistant bacterial strains and the necessity to find new strategies to reduce indiscriminate use of antibiotics, especially in patients where treatment is not indicated. 18,19 The present results suggest that an increase in the mean number of leukocytes of >150% from baseline might be considered a diagnostic aid for detecting the transition to symptomatic UTI. Finding an increase in the number of leukocytes justifies the need for a urine culture and tailored antibiotic treatment of patients with rUTI.…”

Section: Discussionmentioning

confidence: 66%

“…Differentiating ABU from symptomatic UTI is particularly important, because treatment of ABU will do more harm than good, as stated by several authors . The results of the present study should be read in the light of the continuing increase of resistant bacterial strains and the necessity to find new strategies to reduce indiscriminate use of antibiotics, especially in patients where treatment is not indicated . The present results suggest that an increase in the mean number of leukocytes of >150% from baseline might be considered a diagnostic aid for detecting the transition to symptomatic UTI.…”

Section: Discussionmentioning

confidence: 99%