Risk factors of all-cause in-hospital mortality among Korean elderly bacteremic urinary tract infection (UTI) patients.
Urinary tract infection (UTI) is the most frequent cause of bacteremia/sepsis in elderly people and increasing antimicrobial resistance in uropathogens has been observed. To describe the characteristics of bacteremic UTI in elderly patients and to identify the independent risk factors of all-cause in-hospital mortality, a retrospective cohort study of bacteremic UTI patients of age over 65 was performed at a single 2000-bed tertiary hospital. Bacteremic UTI was defined as the isolation of the same organism from both urine and blood within 48 h. Eighty-six elderly bacteremic UTI patients were enrolled. Community-acquired infection was the case for most patients (79.1%), and Escherichia coli accounted for 88.6% (70/79) among Gram-negative organisms. Non-E. coli Gram-negative organisms were more frequent in hospital-acquired cases and male patients while chronic urinary catheter insertion was related with Gram-positive urosepsis. The antibiotic susceptibility among Gram-negative organisms was not different depending on the source of bacteremic UTI, while non-E. coli Gram-negative organisms were less frequently susceptible for cefotaxime, cefoperazone/sulbactam, and aztreonam. All-cause in-hospital mortality was 11.6%, and functional dependency (adjusted hazard ratio=HR=10.9, 95% confidence interval=95%CI=2.2-54.6) and low serum albumin (adjusted HR=27.0, 95%CI=2.0-361.2) were independently related with increased all-cause in-hospital mortality.
Chin
Bum Sik
BS
Division of Infectious Diseases, Department of Internal Medicine, Yonsei University College of Medicine, 250 Seongsanno, Seodaemun-gu, Seoul 120-752, Republic of Korea.
Kim
Myung Soo
MS
Han
Sang Hoon
SH
Shin
So Youn
SY
Choi
Hee Kyung
HK
Chae
Yun Tae
YT
Jin
Sung Joon
SJ
Baek
Ji-Hyeon
JH
Choi
Jun Yong
JY
Song
Young Goo
YG
Kim
Chang Oh
CO
Kim
June Myung
JM
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D055499:Catheter-Related Infections / Q000188:drug therapy / Q000401:mortality; D017714:Community-Acquired Infections / Q000401:mortality; D003428:Cross Infection / Q000188:drug therapy / Q000401:mortality; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D016015:Logistic Models; D008297:Male; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D014546:Urinary Catheterization / Q000009:adverse effects; D014552:Urinary Tract Infections / Q000188:drug therapy / Q000382:microbiology / Q000401:mortality*
D000900:Anti-Bacterial Agents