Urinary Tract Infections in Hospitalized COVID-19 Patients, What's Up, Doc?

Area of Science:

• Infectious Diseases
• Critical Care Medicine
• Microbiology

Background:

• The COVID-19 pandemic may have elevated healthcare-associated infection (HAI) risks.
• Studies on HAI, including urinary tract infections (UTIs) and catheter-associated UTIs (CAUTIs) in COVID-19 patients, show conflicting findings.
• Understanding UTI clinical features and bacterial profiles in hospitalized COVID-19 patients is crucial.

Purpose of the Study:

• To assess the clinical features of UTIs in hospitalized COVID-19 patients.
• To identify bacterial isolates from urine samples of COVID-19 patients with UTIs.
• To differentiate between community-acquired and hospital-acquired UTIs in this cohort.

Main Methods:

• Retrospective observational study.
• Inclusion of 87 hospitalized COVID-19 patients diagnosed with UTIs.
• Analysis of UTI types (CAUTI vs. non-CAUTI), acquisition (community vs. hospital), patient demographics, clinical outcomes, and causative microorganisms.

Main Results:

• 89.6% of UTIs were hospital-acquired (superinfections), with CAUTI being most frequent (67.9%).
• Hospital-acquired UTIs were associated with longer hospitalization (34 vs. 13 days) and higher ICU admission (43.7%) and mortality rates (26.4%).
• E. coli, E. faecalis, and E. faecium were the most common pathogens, with increased incidence of E. faecalis and E. faecium in hospital-acquired UTIs.

Conclusions:

• Hospital-acquired UTIs, especially CAUTIs, are prevalent in COVID-19 patients.
• Prolonged hospitalization, ICU admission, and urethral catheterization contribute to the risk of UTIs, particularly those caused by E. faecalis and E. faecium.
• These findings highlight the need for vigilant infection control measures in hospitalized COVID-19 patients to mitigate UTI risks.