Characteristics of pathogens and mortality predictors of older Chinese patients with nosocomial urinary tract infections

Abstract

Aim:The aim of the present study was to investigate predominant pathogens and predictors of 28-day mortality of older Chinese patients with nosocomial urinary tract infections (NUTI). Methods:We retrospectively studied 1122 older patients (aged ≥60 years) with culture-. The clinical features, microbial distributions and outcomes of these patients were recorded and compared between survival and death patients. Multivariate logistic regression was carried out to identify independent predictors of 28-day mortality.Results: The present results showed the all-cause mortality was 8.3%, and NUTI mortality was 1.43%. The proportions of Candida albicans (P = 0.004), Acinetobacter baumannii (P = 0.045) and Candida tropicalis (P < 0.001) in the death group were significantly higher than those in the survival group. Multivariate analysis showed two novel risk factors for mortality of older patients with NUTI, which were higher Charlson Comorbidity Index (odds ratio [OR] 1.205, 95% confidence interval (CI) 1.088-1.334] and lower level of serum prealbumin (OR 0.995, 95% CI 0.990-0.999). Furthermore, previous use of antibiotics (OR 1.984, 95% CI 1.106-3.559), inappropriate antimicrobial therapy (OR 1.883, 95% CI 1.144-3.098), intensive care unit stay (OR 4.082, 95% CI 2.469-6.749) and higher concentration of serum C-reactive protein (OR 1.005, 95% CI 1.001-1.010) were independent prognostic factors for 28-day mortality in older patients with NUTI.Conclusions: NUTI is associated with a high 28-day in-hospital mortality rate in older patients. We should evaluate the comorbidity, nutritional status, inflammatory markers, department staying and drug sensitivity test, and choose systematic therapy strategies for these older patients with NUTI. DefinitionsCulture-positive urinary tract infection (UTI) was diagnosed by the following criteria. First, the signs or symptoms (fever, 541 |

Risk factors of the fungal urinary tract infections

“…Усиление колонизации мочевых путей грибами происходит при наличии мочевого дренажа, конкремента в мочевых путях и после антибактериальной терапии [4,10,12,16,35]. Однако влияние антибактериальной терапии как единственного фактора риска усиления колонизации грибами Candida у женщин с неосложненной ИМП не подтвердилось в исследовании R.M.…”

“…Пребывание больного в отделении реанимации и интенсивной терапии является независимым фактором риска развития мочевой инфекции, вызванной Candida spp. [4,16,35]. По данным W. Hu et al, у пациентов в возрасте старше 65 лет с кандидурией повышенный индекс коморбидности Чарлсона, снижение уровня преальбумина и повышение уровня С-реактивного белка должны рассматриваться как дополнительные факторы риска повышенной летальности [16].…”

“…При этом уровень летальности не имел существенного отличия в группах пациентов с инвазивным кандидозом или бессимптомной колонизацией Candida auris [15]. Обнаружение грибов Candida в моче наиболее часто происходит у лиц в пожилом возрасте [7,16]. Ряд авторов сообщают, что Candida spp.…”

Factors associated with death in bedridden patients in China: A longitudinal study

“…A retrospective study reported that urinary tract infection contributed to high 28-day mortality rate in hospitalized Chinese older patients [31]. Catheter-associated urinary tract infection was also accompanied by an increase in mortality [32].…”

Comparison of Incidence of Urinary Tract Infection in Diabetic vs Non-Diabetic and Associated Pathogens

“…Common pathogens involved are Escherichia coli, Klebsiella spp., Mycoplasma spp., Enterobacter spp., Staphylococcus aureus, Candida albicans, and worms like threadworms, flukeworms, etc. Of these, E. coli is the most common cause of UTI [13,14].…”