Bacteremic versus Non-Bacteremic Urinary Tract Infections: Predictors of Poor Clinical Outcome

Urinary tract infections (UTIs) are associated with increased morbidity and mortality, yet data on the importance of secondary bacteremia remain scarce.

This retrospective, single-center study was conducted at a tertiary university hospital and included patients, hospitalized for UTIs, in order to assess the impact of secondary bacteremia on clinical outcomes (need for surgery, antibiotic change or death) and identify predictors for its presence.

A total of 232 patients were included, with 56 (24.1%) developing secondary bacteremia. The bacteremia group exhibited higher CRP levels (18 mg/dL vs. 8 mg/dL, p < 0.01), lower hemoglobin (11.1 vs. 12 g/dL, p < 0.01), and higher disease severity scores. Hospital-acquired infections were an independent predictor of bacteremia (aOR: 4.440, p = 0.045). Patients with bacteremia exhibited longer hospital stays (8.5 vs. 4 days, p < 0.01) while its presence was independently associated with mortality (OR 11.01, 95% CI 1.19-101.50, p = 0.034). Multidrug-resistant (MDR) pathogens were the main prognostic factor for poor outcomes (aOR: 7.792, p < 0.001).

Our study underscores the need for antimicrobial resistance surveillance, early detection and prompt intervention to improve patient outcomes.