Nosocomial urinary tract infections caused by Pseudomonas aeruginosa and Acinetobacter species: Sensitivity to antibiotics and risk factors

Djordjevic, Zorana; Folić, Marko; Zivic, Ziva; Markovic, V.M.; Janković, Slobodan

doi:10.1016/j.ajic.2013.02.018

Cited by 40 publications

(38 citation statements)

References 26 publications

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“…Urinary catheter was also significantly associated with PA urinary sepsis. This association was classically described, although the findings that supported it were based on nosocomial infections . Male sex has been associated with PA urinary sepsis in our study and others .…”

Section: Discussionsupporting

confidence: 80%

“…Male sex has been associated with PA urinary sepsis in our study and others . Urinary tract neoplasia and recurrent UTI, which were not significantly associated with PA urinary sepsis in the multivariate analysis (Table ), have not been evaluated in other studies …”

Section: Discussioncontrasting

confidence: 55%

“…To our knowledge, there is no study comparing the predictive factors and severity of community‐acquired PA urinary sepsis with urinary sepsis caused by other microorganisms. Previous studies on this subject were based on cases including critical care patients with ventilator‐associated pneumonia or bacteraemia from different sources, with nosocomial infections in most cases …”

Section: Discussionmentioning

confidence: 99%

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Community‐onset Pseudomonas aeruginosa urinary sepsis in elderly people: Predictive factors, adequacy of empirical therapy and outcomes

et al. 2019

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PurposeTo know the predictive factors for Pseudomonas aeruginosa (PA) urinary sepsis in hospitalised elderly patients coming from community, the adequacy of empirical antibiotic therapy and its outcomes. MethodsRetrospective case–control study conducted between 2007 and 2017. Patients aged 65 years or older with PA urinary sepsis were included as cases. Three age‐matched controls, with urinary sepsis caused by other microorganisms, were selected for each case. Predictors for PA urinary sepsis were determined by logistic regression analysis. Adequacy of empirical antibiotic therapy and outcomes were compared between both groups. ResultsA total of 332 patients, from which 83 were cases, were included. Predictive factors for PA urinary sepsis were as follows: male sex (OR 3.16, 95% CI 1.61‐6.10; P < .001), urinary catheter (OR 3.25, 95% CI 1.73‐6.11; P < .001) and healthcare‐associated infection (OR 5.52, 95% CI 1.76 −17.29; P = .003). Inadequate empirical antimicrobial therapy (IEAT) and length of hospital stay were higher in PA group (42% vs 24%, P = .002; 7.45 ± 4.36 days vs 6.43 ± 3.82 days, P = .045, respectively), but mortality was not different (7.2% vs 8.8%, P = .648). ConclusionsPseudomonas aeruginosa urinary sepsis in elderly people was associated with male sex, urinary catheter and healthcare‐associated infection. These infections had a higher rate of IEAT and a longer hospital stay than urinary sepsis caused by other microorganisms.

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Section: Discussionsupporting

confidence: 80%

Section: Discussioncontrasting

confidence: 55%

Section: Discussionmentioning

confidence: 99%

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Community‐onset Pseudomonas aeruginosa urinary sepsis in elderly people: Predictive factors, adequacy of empirical therapy and outcomes

et al. 2019

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“…Within the hospital setting, 7–10% of urinary tract infections are caused by Pseudomonas aeruginosa ( P . aeruginosa ) [3, 4]. P .…”

Section: Introductionmentioning

confidence: 99%

Pseudomonas aeruginosa urinary tract infections in hospitalized patients: Mortality and prognostic factors

et al. 2017

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BackgroundThe aim of this study was to analyze the mortality and predictors of 30-day mortality among hospitalized patients with Pseudomonas aeruginosa urinary tract infection (PAUTI) and the impact of antibiotic treatment on survival.MethodsPatients admitted to our hospital with PAUTI or those diagnosed of PAUTI during hospitalization for other disease between September 2012 and September 2014 were included. Repeated episodes from the same patient were excluded. Database with demographic, clinical and laboratory ítems was created. Empirical and definitive antibiotic therapy, antimicrobial resistance and all-cause mortality at 30 and 90 days were included.Results62 patients were included, with a mean age of 75 years. 51% were male. Mortality was 17.7% at 30 days and 33.9% at 90 days. Factors associated with reduced survival at 30 days were chronic liver disease with portal hypertension (P<0,01), diabetes mellitus (P = 0,04) chronic renal failure (P = 0,02), severe sepsis or septic shock (P<0,01), Charlson index > 3 (P = 0.02) and inadequated definitive antibiotic treatment (P<0,01). Independent risk factors for mortality in multivariate analysis were advanced chronic liver disease (HR 77,4; P<0,01), diabetes mellitus (HR 3,6; P = 0,04), chronic renal failure (HR 4,1; P = 0,03) and inadequated definitive antimicrobial treatment (HR 6,8; P = 0,01).ConclusionsPAUTI are associated with high mortality in hospitalized patients, which increases significantly in those with severe comorbidity such as chronic renal failure, advanced liver disease or diabetes mellitus. Inadequated antibiotic treatment is associated with poor outcome, which remarks the importance of adjusting empirical antibiotic treatment based on the microbiological susceptibility results.

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“…Among the numerous factors 1066 which have been established as significant for the development of antimicrobial resistance, gender and age are now emerging to be important when determining empiric therapy. However, in Serbia studies investigating the role of age and gender are nonexistent; studies that have been published regarding UTIs in the country were oriented towards resistance of hospital-acquired (HA) infections [8] and resistance of pathogens in the paediatric population [9,10].…”

Section: Introductionmentioning

confidence: 99%

Antimicrobial resistance in patients with urinary tract infections and the impact on empiric therapy in Serbia

Zec

Despotović²,

Spurnic-Radovanovic³

et al. 2016

J Infect Dev Ctries

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Introduction: Surveillance of antimicrobial resistance is essential in establishing treatment guidelines for urinary tract infections. The aim of this pilot study was to analyse resistance rates of pathogens, across different demographics and determine whether adjustments in empiric therapy should be considered for different age and gender groups. Methodology: A 5-year retrospective study included 256 patients hospitalised, under the initial diagnosis of Fever of Unknown Origin who were then subsequently diagnosed with a urinary tract infection at the Clinic for Infectious and Tropical Diseases, Clinical Centre of Serbia. Patients were evaluated using demographic, clinical, and antimicrobial resistance data with appropriate statistical analysis including ANOVA significance testing, univariate, and multivariate analysis. Results: Resistance rates were above the threshold of 20% for the majority of the antimicrobials tested, the only exception being carbapenems. Amikacin, cefepime, and norfloxacin were agents that could be effectively used as empiric therapy in younger adults with resistance rates of 4.2, 8.0, and 10.0%, respectively. Moderate resistance rates of 17.4% for amikacin and 19.1% for cefepime were observed in the age group 35-64 years. High resistance rates were observed for all antimicrobials among patients 65 years and over. Among male patients, resistance rates to most antimicrobials were high. In female patients, amikacin and cefepime had resistance rates less than 20%. Younger age presented as a negative risk factor for infection by a multi-drug resistant pathogen. Conclusion: Age and gender demonstrated to be significant factors for determining proper empiric therapy; large-scale studies from Serbia are needed to solidify these findings.

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Nosocomial urinary tract infections caused by Pseudomonas aeruginosa and Acinetobacter species: Sensitivity to antibiotics and risk factors

Cited by 40 publications

References 26 publications

Community‐onset Pseudomonas aeruginosa urinary sepsis in elderly people: Predictive factors, adequacy of empirical therapy and outcomes

Community‐onset Pseudomonas aeruginosa urinary sepsis in elderly people: Predictive factors, adequacy of empirical therapy and outcomes

Pseudomonas aeruginosa urinary tract infections in hospitalized patients: Mortality and prognostic factors

Antimicrobial resistance in patients with urinary tract infections and the impact on empiric therapy in Serbia

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