Bacteraemic urinary tract infections may mimic respiratory infections: a nested case-control study
E Denis1, N Martis2, F Guillouet-de Salvador2
1Médecine Interne, Centre Hospitalier Antibes Juan-les-Pins, Nice, France.
Summary
Bacteraemic urinary infections (BUI) often present with respiratory symptoms, overshadowing typical urinary signs. Early recognition of these respiratory indicators is crucial for accurate diagnosis and effective clinical decision-making in urinary tract infections (UTI).
Area of Science:
- Infectious Diseases
- Pulmonology
- Urology
Background:
- Urinary tract infections (UTI) can sometimes present with respiratory symptoms.
- Bacteraemic urinary infections (BUI), where bacteria are present in both urine and blood, may have distinct clinical presentations.
- Understanding these presentations is key for timely and accurate diagnosis.
Purpose of the Study:
- To investigate the association between respiratory symptoms and bacteraemic urinary tract infections (UTI).
- To compare the prevalence of respiratory and urinary symptoms in patients with BUI versus non-bacteraemic UTI (NBUI).
Main Methods:
- A nested case-control study was conducted from January 2011 to June 2015.
- Cases were patients with BUI (Enterobacteriaceae in blood and urine cultures).
- Controls were patients with NBUI (fever, positive urine culture, negative blood culture), matched for age, gender, and comorbidities.
Main Results:
- 58% of BUI patients exhibited respiratory signs compared to 20% of NBUI patients (p < 0.001).
- Urinary symptoms were less frequent in BUI patients (54%) than in NBUI patients (71%) (p = 0.013).
- Multivariate analysis showed BUI was associated with abnormal pulmonary auscultation (AOR 5.91; p < 0.001).
Conclusions:
- Bacteraemic urinary infections are significantly associated with a higher prevalence of respiratory signs.
- Respiratory symptoms in UTI may indicate a bacteraemic condition and can overshadow typical urinary symptoms.
- These findings highlight the importance of considering respiratory signs in the clinical evaluation of UTI to improve diagnostic accuracy.
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