title: Risk factors of all-cause in-hospital mortality among Korean elderly bacteremic urinary tract infection (UTI) patients.
abstract: 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.
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine, Yonsei University College of Medicine, 250 Seongsanno, Seodaemun-gu, Seoul 120-752, Republic of Korea.
authors.forename: Bum Sik
authors.initials: BS
authors.lastname: Chin
authors.forename: Myung Soo
authors.initials: MS
authors.lastname: Kim
authors.forename: Sang Hoon
authors.initials: SH
authors.lastname: Han
authors.forename: So Youn
authors.initials: SY
authors.lastname: Shin
authors.forename: Hee Kyung
authors.initials: HK
authors.lastname: Choi
authors.forename: Yun Tae
authors.initials: YT
authors.lastname: Chae
authors.forename: Sung Joon
authors.initials: SJ
authors.lastname: Jin
authors.forename: Ji-Hyeon
authors.initials: JH
authors.lastname: Baek
authors.forename: Jun Yong
authors.initials: JY
authors.lastname: Choi
authors.forename: Young Goo
authors.initials: YG
authors.lastname: Song
authors.forename: Chang Oh
authors.initials: CO
authors.lastname: Kim
authors.forename: June Myung
authors.initials: JM
authors.lastname: Kim
mesh_terms: 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*
chemical_list: D000900:Anti-Bacterial Agents