Author, as appears in the article.: Gomila A, Carratalà J, Eliakim-Raz N, Shaw E, Tebé C, Wolkewitz M, Wiegand I, Grier S, Vank C, Cuperus N, Van den Heuvel L, Vuong C, MacGowan A, Leibovici L, Addy I, Pujol M, RESCUING Study Group and Study Sites

Department: Ciències Mèdiques Bàsiques

URV's Author/s: TEBÉ CORDOMÍ, CRISTIAN

Keywords: Urinary Tract Infection Turkey (Republic) Retrospective Study Recurrent Disease Quinoline Derived Antiinfective Agent Priority Journal Penicillin Derivative Observational Study Nonhuman Multidrug Resistance Multicenter Study MORTALITY RISK Mortality rate Mortality Male Major Clinical Study Length of Stay Israel Human Hospitalization Hospital Readmission Hospital Patient Hospital Discharge Gram-negative infections Gram Negative Bacterium Female Europe Controlled Study colony forming unit Cohort Analysis Clinical outcome Charlson Comorbidity Index Cephalosporin Catheter-associated urinary tract infection Catheter Infection Carbapenem Article Antimicrobial Resistance Antiinfective Agent Antibiotic Resistance Aminoglycoside Aged Adult

Abstract: © 2019 The Author(s). Background: Although catheter-associated urinary tract infection (CA-UTI) is a major healthcare-related problem worldwide, there is a scarcity of current data from countries with high antimicrobial resistance rates. We aimed to determine the clinical outcomes of patients with CA-UTI compared to those of patients with other sources of complicated urinary tract infection (cUTI), and to assess the impact of antimicrobial resistance. We also aimed to identify the factors influencing 30-day mortality among patients with CA-UTI. Methods: This was a multicentre, multinational retrospective cohort study including hospitalised adults with cUTI between January 2013 and December 2014 in twenty hospitals from eight countries from southern Europe, Turkey and Israel. The primary endpoint was 30-day mortality. The secondary endpoints were length of hospital stay, symptom improvement after 7 days' treatment, symptom recurrence at 30 days and readmission 60 days after hospital discharge. Results: Of the 807 cUTI episodes, 341 (42.2%) were CA-UTIs. The time from catheter insertion to cUTI diagnosis was less than 2 weeks in 44.6% of cases. Overall, 74.5% of cases had hospital or healthcare-acquired CA-UTI. Compared to patients with other cUTI aetiologies, those with CA-UTI had the following characteristics: They were more frequently males, older, admitted for a reason other than cUTI and admitted from a long-term care facility; had higher Charlson's comorbidity index; and more frequently had polymicrobial infections and multidrug-resistant Gram-negative bacteria (MDR-GNB). Patients with CA-UTI also had significantly higher 30-day mortality rates (15.2% vs 6%) and longer hospital stay (median 14 [interquartile range-IQR-7-27] days vs 8 [IQR 5-14] days) than patients with cUTI of other sources. After adjusting for confounders, CA-UTI was not independently associated with an increased risk of mortality (odds ratio, 1.40; 95% confidence interval, 0.77-2.54), and neither was the presence of MDR-GNB. Conclusions: CA-UTI was the most frequent source of cUTI, affecting mainly frail patients. The mortality of patients with CA-UTI was high, though this was not directly related to the infection.

Thematic Areas: Public, Environmental & Occupational Health Public Health, Environmental and Occupational Health Pharmacology (Medical) Microbiology (Medical) Microbiology Infectious Diseases

licence for use: https://creativecommons.org/licenses/by/3.0/es/

Author's mail: cristian.tebe@urv.cat

Author identifier: 0000-0003-2320-1385

ISSN: 20472994

Record's date: 2020-08-07

Papper version: info:eu-repo/semantics/publishedVersion

Link to the original source: https://aricjournal.biomedcentral.com/articles/10.1186/s13756-019-0656-6

Licence document URL: http://repositori.urv.cat/ca/proteccio-de-dades/

Papper original source: ANTIMICROBIAL RESISTANCE AND INFECTION CONTROL. (ISSN/ISBN: 20472994). 8(1): 198

APA: Gomila A, Carratalà J, Eliakim-Raz N, Shaw E, Tebé C, Wolkewitz M, Wiegand I, Grier S, Vank C, Cuperus N, Van den Heuvel L, Vuong C, MacGowan A, Leibovici L, Addy I, Pujol M, RESCUING Study Group and Study Sites (2019). Clinical outcomes of hospitalised patients with catheter-associated urinary tract infection in countries with a high rate of multidrug-resistance: The COMBACTE-MAGNET RESCUING study. ANTIMICROBIAL RESISTANCE AND INFECTION CONTROL, 8(1), 198-. DOI: 10.1186/s13756-019-0656-6

Article's DOI: 10.1186/s13756-019-0656-6

Entity: Universitat Rovira i Virgili

Journal publication year: 2019

Publication Type: Journal Publications