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J Infect. 2012 May;64(5):478-83. doi: 10.1016/j.jinf.2012.01.010. Epub 2012 Jan 20.

Community-onset healthcare-related urinary tract infections: comparison with community and hospital-acquired urinary tract infections.

Author information

1
Service of Internal Medicine and Infectious Diseases, Hospital Universitari del Mar, Parc de Salut MAR, Barcelona, Spain. silvi_agui@hotmail.com

Abstract

OBJECTIVES:

To analyze the characteristics of infection, adequacy of empirical treatment and outcome of patients with community-onset healthcare-associated (HCA) urinary tract infections (UTI) and compare them with hospital (HA) and community-acquired (CA) UTI.

METHODS:

Prospective observational cohort study performed at a university 600-bed hospital between July 2009 and February 2010. Patients with UTI requiring hospital admission were included. Epidemiological, clinical and outcome data were recorded.

RESULTS:

251 patients were included. Patients with community-onset HCA UTI were older, had more co-morbidities and had received previous antimicrobial treatment more frequently than CA UTI (p = 0.02, p = 0.01 and p < 0.01). ESBL-Escherichia coli and Pseudomonas aeruginosa infections were more frequent in HCA than in CA UTI (p = 0.03 and p < 0.01). Inadequate empirical treatment was not significantly different between community-onset HCA and CA. Factors related to mortality were P. aeruginosa infection (OR 6.51; 95%CI: 1.01-41.73), diabetes mellitus (OR 22.66; 95%CI: 3.61-142.21), solid neoplasia (OR 22.48; 95%CI: 3.38-149.49) and age (OR 1.15; 95%CI 1.03-1.28).

CONCLUSIONS:

Epidemiological, clinical and microbiological features suggest that community-onset HCA UTI is different from CA and similar to HA UTI. However, in our series inadequate empirical antimicrobial therapy and mortality were not significantly higher in community-onset HCA than in CA UTI.

PMID:
22285591
DOI:
10.1016/j.jinf.2012.01.010
[Indexed for MEDLINE]

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