• Am. J. Med. Sci. · Sep 2016

    Observational Study

    Effect of Bacteremia in Elderly Patients With Urinary Tract Infection.

    • Arturo Artero, Ana Esparcia, José M Eiros, Manuel Madrazo, Juan Alberola, and José M Nogueira.
    • Department of Internal Medicine, Hospital Universitario Dr. Peset, Universitat de València, Valencia, Spain. Electronic address: arturo.artero@uv.es.
    • Am. J. Med. Sci. 2016 Sep 1; 352 (3): 267-71.

    IntroductionThe clinical effect of bacteremia on outcomes in urinary tract infection (UTI) is still debated. This study aims to examine the clinical effect of bacteremia in elderly patients with UTI requiring hospital admission.MethodsThis retrospective observational study recorded the clinical features, microbiology and outcomes in a Spanish cohort of patients aged ≥65 years hospitalized for UTI in whom blood cultures were performed in the emergency department. The primary outcome of the study was in-hospital mortality.ResultsOf 333 patients, with a mean age of 81.6 years, 137 (41.1%) had positive blood cultures. Escherichia coli, with 223 (66.9%) cases, was the most common microorganism isolated. Independent risk factors of bacteremia were temperature >38°C, heart rate >90bpm and inversely both Enterococcus faecalis and Pseudomonas aeruginosa. Bacteremia was not associated with the length of stay in hospital (6.96 ± 3.50 days versus 7.33 ± 5.54 days, P = 0.456). Mortality rate was 9.3% with no significant difference between bacteremic and nonbacteremic cases (8.8% and 9.7%, respectively, P = 0.773). In-hospital mortality analyzed by logistic regression was associated with McCabe index >2 (20.5% survival versus 66.7% death, adjusted odds ratio = 6.31, 95% CI: 2.71-14.67; P < 0.001) but not with bacteremia (41.4% survival versus 38.7% death, adjusted odds ratio = 0.99, 95% CI: 0.43-2.29; P = 0.992).ConclusionsOur study suggests that the presence or absence of bacteremia in elderly people with UTI requiring hospitalization does not have an influence on outcomes such as in-hospital mortality or length of stay.Copyright © 2016 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.

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