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An In Vitro Bladder Model of Catheter-Associated Urinary Tract Infection
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Risk Factors for Bacteremia and Its Clinical Impact on Complicated Community-Acquired Urinary Tract Infection
Manuel Madrazo1, Ian López-Cruz1, Laura Piles1
1Doctor Peset University Hospital, University of Valencia, 46017 Valencia, Spain.
Microorganisms
|August 26, 2023
Summary
Fever and elevated procalcitonin are key risk factors for bacteremia in complicated urinary tract infections (UTIs). While bacteremia may slightly worsen outcomes, it did not significantly increase 30-day mortality in this study.
Area of Science:
- Infectious Diseases
- Clinical Microbiology
- Critical Care Medicine
Background:
- Bacteremia's role in urinary tract infection (UTI) severity is debated.
- Complicated community-acquired UTIs pose significant clinical challenges.
Purpose of the Study:
- To identify risk factors for bacteremia in hospitalized patients with complicated UTIs.
- To assess the clinical impact of bacteremia on UTI prognosis and mortality.
Main Methods:
- Prospective observational study of 279 patients with complicated community-acquired UTIs.
- Multivariate analysis to determine risk factors for bacteremia and mortality.
- Comparison of clinical variables and outcomes between patients with and without bacteremia.
Main Results:
- 37.6% of patients had positive blood cultures (bacteremia).
- Risk factors for bacteremia included fever (≥ 38 °C) and elevated procalcitonin (≥ 0.5 ng/mL).
- Bacteremia was not significantly associated with increased 30-day mortality, though outcomes were slightly worse.
Conclusions:
- Febrile UTIs and elevated procalcitonin are significant risk factors for bacteremia.
- While bacteremia may indicate a more severe infection, it does not independently predict 30-day mortality in this cohort.
- Quick SOFA and low Barthel Index predict mortality in complicated UTIs.
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