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2 results on '"Urinary devices"'

1. Characteristics and Outcomes of Staphylococcus aureus Bloodstream Infection Originating From the Urinary Tract: A Multicenter Cohort Study.

Author

Grillo, Sara, Cuervo, Guillermo, Carratalà, Jordi, Grau, Immaculada, Llaberia, Mariona, Aguado, José María, Lopez-Cortés, Luis Eduardo, Lalueza, Antonio, Sanjuan, Rafael, Sanchez-Batanero, Ana, Ardanuy, Carmen, García-Somoza, Dolors, Tebé, Cristian, and Pujol, Miquel

Subjects
*STAPHYLOCOCCUS aureus infections, *URINARY organs, *COHORT analysis, *URINARY catheterization, *URINARY tract infections
Abstract

Background Staphylococcus aureus bloodstream infection (SABSI) arising from a urinary tract source (UTS) is poorly understood. Methods We conducted a retrospective analysis in 3 major teaching hospitals in Spain of prospectively collected data of hospitalized patients with SABSI. SABSI-UTS was diagnosed in patients with urinary tract symptoms and/or signs, no evidence of an extra-urinary source of infection, and a urinary S. aureus count of ≥105 cfu/mL. Susceptibility of S. aureus strains and patient mortality were compared between SABSI from UTS (SABSI-UTS) and other sources (SABSI-other). Results Of 4181 episodes of SABSI, we identified 132 (3.16%) cases of SABSI-UTS that occurred predominantly in patients who were male, had high Charlson comorbidity scores, were dependent for daily life activities, and who had undergone urinary catheterization and/or urinary manipulation before the infection. SABSI-UTS was more often caused by MRSA strains compared with SABSI-other (40.9% vs 17.5%; P <.001). Patients with SABSI-UTS caused by MRSA more often received inadequate empirical treatment compared with those caused by susceptible strains (59.7% vs 23.1%; P <.001). The 30-day case fatality rate was lower in patients with SABSI-UTS than in those with SABSI-other (14.4% vs 23.8%; P =.02). Factors independently associated with mortality were dependence for daily activities (aOR, 3.877; 95% CI, 1.08–13.8; P =.037) and persistent bacteremia (aOR, 7.88; 95% CI, 1.57–39.46; P =.012). Conclusions SABSI-UTS occurs predominantly in patients with severe underlying conditions and in those who have undergone urinary tract manipulation. Moreover, it is frequently due to MRSA strains and causes significant mortality. [ABSTRACT FROM AUTHOR]

Published
2020
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2. Characteristics and Outcomes of Staphylococcus aureus Bloodstream Infection Originating From the Urinary Tract: A Multicenter Cohort Study

Author

Ana Sanchez-Batanero, Cristian Tebé, José María Aguado, Rafael San-Juan, Luis Eduardo López-Cortés, Miquel Pujol, Jordi Carratalà, Sara Grillo, Antonio Lalueza, Guillermo Cuervo, Carmen Ardanuy, Dolors García-Somoza, Mariona Llaberia, Immaculada Grau, Instituto de Salud Carlos III, Ministerio de Economía, Industria y Competitividad (España), Red Española de Investigación en Patología Infecciosa, European Commission, [Grillo,S, Cuervo,G, Carratalà,J, Grau,I, Llaberia,M, Pujol,M] Department of Infectious Diseases, Bellvitge University Hospital, Barcelona, Spain. [Grillo,S, Ardanuy,C, García-Somoza,D, Pujol,M] Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain. [Aguado,JM, Lalueza,A, Sanjuan,R] Unit of Infectious Diseases, 12 de Octubre University Hospital, Madrid, Spain. [Aguado,JM, Sanjuan,R] Research Institute Hospital 12 de Octubre (I+12), Madrid, Spain. [Lopez-Cortés,LE] Unidad Clínica de Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Hospital Universitario Virgen Macarena/CSIC/Departamento de Medicina, Universidad de Sevilla/Instituto de Biomedicina de Sevilla (IBiS), Seville, Spain. [Sanchez-Batanero,A] Unidad Clínica de Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Hospital Universitario Virgen Macarena/CSIC/Departamento de Medicina, Instituto de Biomedicina de Sevilla (IBiS), Seville, Spain. [Ardanuy,C, García-Somoza,D] Department of Microbiology, Bellvitge University Hospital, Barcelona, Spain. [Grau,I, García-Somoza,D] CIBER of Respiratory Diseases, ISCIII, Madrid, Spain. [Grillo,S, Aguado,JM, Lopez-Cortés,LE, Sanjuan,R, and Ardanuy,C] Spanish Network for Research in Infectious Diseases (REIPI), Seville, Spain. [Ardanuy,C] Departmentos de Fundamentos Clínicos and Patología y Terapeútica Experimental, School of Medicine, of University of Barcelona (UB), Barcelona, Spain. [Aguado,JM] Complutense University of Madrid, Madrid, Spain. [Tebé,C] Biostatistics Unit, Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, Spain. [Tebé,C] Basic Clinical Practice Department, Rovira Virgili University, Reus, Spain. [Carratalà,J] University of Barcelona (UB), Barcelona, Spain.

Subjects
0301 basic medicine, medicine.medical_specialty, Staphylococcus aureus, medicine.medical_treatment, Urinary system, 030106 microbiology, Check Tags::Male [Medical Subject Headings], Bacteremia, medicine.disease_cause, Urinary catheterization, Diseases::Bacterial Infections and Mycoses::Infection::Urinary Tract Infections [Medical Subject Headings], Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings], 03 medical and health sciences, 0302 clinical medicine, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies::Retrospective Studies [Medical Subject Headings], Aparell urinari, Internal medicine, Case fatality rate, Infecciones estafilocócicas, Medicine, Staphylococcal infections, 030212 general & internal medicine, Infecciones urinarias, Organisms::Bacteria::Endospore-Forming Bacteria::Gram-Positive Endospore-Forming Bacteria::Gram-Positive Endospore-Forming Rods::Staphylococcaceae::Staphylococcus::Staphylococcus aureus::Methicillin-Resistant Staphylococcus aureus [Medical Subject Headings], Anatomy::Urogenital System::Urinary Tract [Medical Subject Headings], Diseases::Bacterial Infections and Mycoses::Bacterial Infections::Gram-Positive Bacterial Infections::Staphylococcal Infections [Medical Subject Headings], Geographical Locations::Geographic Locations::Europe::Spain [Medical Subject Headings], Urinary tract infection, business.industry, Diseases::Bacterial Infections and Mycoses::Bacterial Infections::Bacteremia [Medical Subject Headings], Infeccions per estafilococs, Urinary devices, medicine.disease, Comorbidity, Methicillin-resistant Staphylococcus aureus, Urinary organs, Infectious Diseases, Oncology, Organisms::Bacteria::Gram-Positive Bacteria::Bacillales::Staphylococcaceae::Staphylococcus::Staphylococcus aureus [Medical Subject Headings], Bacteriemia, business, Cohort study
Abstract

[Background] Staphylococcus aureus bloodstream infection (SABSI) arising from a urinary tract source (UTS) is poorly understood., [Methods] We conducted a retrospective analysis in 3 major teaching hospitals in Spain of prospectively collected data of hospitalized patients with SABSI. SABSI-UTS was diagnosed in patients with urinary tract symptoms and/or signs, no evidence of an extra-urinary source of infection, and a urinary S. aureus count of ≥105 cfu/mL. Susceptibility of S. aureus strains and patient mortality were compared between SABSI from UTS (SABSI-UTS) and other sources (SABSI-other)., [Results] Of 4181 episodes of SABSI, we identified 132 (3.16%) cases of SABSI-UTS that occurred predominantly in patients who were male, had high Charlson comorbidity scores, were dependent for daily life activities, and who had undergone urinary catheterization and/or urinary manipulation before the infection. SABSI-UTS was more often caused by MRSA strains compared with SABSI-other (40.9% vs 17.5%; P < .001). Patients with SABSI-UTS caused by MRSA more often received inadequate empirical treatment compared with those caused by susceptible strains (59.7% vs 23.1%; P < .001). The 30-day case fatality rate was lower in patients with SABSI-UTS than in those with SABSI-other (14.4% vs 23.8%; P = .02). Factors independently associated with mortality were dependence for daily activities (aOR, 3.877; 95% CI, 1.08–13.8; P = .037) and persistent bacteremia (aOR, 7.88; 95% CI, 1.57–39.46; P = .012)., [Conclusions] SABSI-UTS occurs predominantly in patients with severe underlying conditions and in those who have undergone urinary tract manipulation. Moreover, it is frequently due to MRSA strains and causes significant mortality., This work was supported by Plan Nacional de I+D+i 2017–2021 and Instituto de Salud Carlos III, Subdirección General de Redes y Centros de Investigación Cooperativa, Ministerio de Economía, Industria y Competitividad, Spanish Network for Research in Infectious Diseases (REIPI RD16/0016/0005, RD16/0016/0002, RD16/0016/0001) and was co-financed by the European Development Regional Fund “A way to achieve Europe,” Operative program Intelligent Growth 2014–2020.

Published
2020

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