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

Silvia Aguilar-Duran*, Juan P. Horcajada, Luisa Sorlí, Milagro Montero, Margarita Salvadó, Santiago Grau, Julià Gómez, Hernando Knobel

*Corresponding author for this work

Research output: Contribution to journalArticleResearchpeer-review

45 Citations (Scopus)

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.

Original languageAmerican English
Pages (from-to)478-483
Number of pages6
JournalJournal of Infection
Volume64
Issue number5
DOIs
Publication statusPublished - May 2012

Keywords

  • Antimicrobial resistance
  • Healthcare-associated infections
  • Urinary tract infection

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