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Am J Infect Control. 2006 Sep;34(7):401-7.

Risk factors for nosocomial urinary tract-related bacteremia: a case-control study.

Author information

1
Center for Practice Management and Outcomes Research, Ann Arbor VA Health Services Research and Development Center of Excellence, Ann Arbor, MI, USA. saint@umich.edu

Abstract

BACKGROUND:

Risk factors for bacteremia in patients with hospital-acquired bacteriuria are largely unknown. Given the morbidity and costs associated with nosocomial bacteremia, determining risk factors could enhance the safety of hospitalized patients.

METHODS:

We conducted a case-control study within the Veterans Affairs Puget Sound Health Care System. A patient hospitalized between 1984 and 1999 from whom a urine culture and a blood culture grew the same organism > or =48 hours after admission was considered a case. Control patients were those with significant bacteriuria detected > or =48 hours after admission who did not have a positive blood culture. We used logistic regression to determine independent risk factors for bacteremia.

RESULTS:

There were 95 cases and 142 controls. Independent, statistically significant predictors of bacteremia included immunosuppressant therapy within 14 days of bacteriuria (odds ratio [OR], 8.13); history of malignancy (OR, 1.94); male sex (OR, 1.88); cigarette use in the past 5 years (OR, 1.26); number of hospital days before bacteriuria (OR, 1.03); and antibiotic use within 3 days of bacteriuria (OR, 0.76). Corticosteroid use within 7 days of bacteriuria predicted bacteremia in patients <70 years old (OR, 14.24). Similarly, patients <70 years old were more likely to develop bacteremia if they had diabetes mellitus (OR, 6.19).

CONCLUSION:

Delineating risk factors for nosocomial urinary tract-related bacteremia can help target appropriate preventive practices at the highest risk patients.

PMID:
16945684
DOI:
10.1016/j.ajic.2006.03.001
[Indexed for MEDLINE]
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