Please use this identifier to cite or link to this item: http://hdl.handle.net/2445/168077
Title: 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
Author: Gomila, Aina
Carratalà, Jordi
Eliakim Raz, Noa
Shaw Perujo, Evelyn
Tebé, Cristian
Wolkewitz, Martin
Wiegand, Irith
Grier, Sally
Vank, Christiane
Cuperus, Nienke
Van Den Heuvel, Leonard
Vuong, Cuong
Macgowan, Alasdair Peter
Leibovici, Leonard
Addy, Ibironke
Pujol Rojo, Miquel
Keywords: Resistència als medicaments
Infeccions del tracte urinari
Malalts hospitalitzats
Drug resistance
Urinary tract infections
Hospital patients
Issue Date: 3-Dec-2019
Publisher: BioMed Central
Abstract: 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.
Note: Reproducció del document publicat a: https://doi.org/10.1186/s13756-019-0656-6
It is part of: Antimicrobial Resistance And Infection Control, 2019-12-03, vol. 8, num. 198
URI: http://hdl.handle.net/2445/168077
Related resource: https://doi.org/10.1186/s13756-019-0656-6
Appears in Collections:Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))

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