Articles producció científica> Ciències Mèdiques Bàsiques

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

  • Dades identificatives

    Identificador: imarina:6009474
    Autors:
    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
    Resum:
    © 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 w
  • Altres:

    Autor segons l'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
    Departament: Ciències Mèdiques Bàsiques
    Autor/s de la URV: TEBÉ CORDOMÍ, CRISTIAN
    Paraules clau: 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
    Resum: © 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.
    Àrees temàtiques: Public, Environmental & Occupational Health Public Health, Environmental and Occupational Health Pharmacology (Medical) Microbiology (Medical) Microbiology Infectious Diseases
    Accès a la llicència d'ús: https://creativecommons.org/licenses/by/3.0/es/
    Adreça de correu electrònic de l'autor: cristian.tebe@urv.cat
    Identificador de l'autor: 0000-0003-2320-1385
    ISSN: 20472994
    Data d'alta del registre: 2020-08-07
    Versió de l'article dipositat: info:eu-repo/semantics/publishedVersion
    Enllaç font original: https://aricjournal.biomedcentral.com/articles/10.1186/s13756-019-0656-6
    Referència a l'article segons font original: ANTIMICROBIAL RESISTANCE AND INFECTION CONTROL. (ISSN/ISBN: 20472994). 8(1): 198
    Referència de l'ítem segons les normes 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
    URL Document de llicència: https://repositori.urv.cat/ca/proteccio-de-dades/
    DOI de l'article: 10.1186/s13756-019-0656-6
    Entitat: Universitat Rovira i Virgili
    Any de publicació de la revista: 2019
    Tipus de publicació: Journal Publications
  • Paraules clau:

    Infectious Diseases,Microbiology,Microbiology (Medical),Pharmacology (Medical),Public Health, Environmental and Occupational Health,Public, Environmental & Occupational Health
    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
    Public, Environmental & Occupational Health
    Public Health, Environmental and Occupational Health
    Pharmacology (Medical)
    Microbiology (Medical)
    Microbiology
    Infectious Diseases
    20472994
  • Documents:

  • Cerca a google

    Search to google scholar