Risk factors for bacteremia in urinary tract infections attended in the emergency department.

Link to article at PubMed

Related Articles

Risk factors for bacteremia in urinary tract infections attended in the emergency department.

Intern Emerg Med. 2016 Nov 18;

Authors: Lalueza A, Sanz-Trepiana L, Bermejo N, Yaiza B, Morales-Cartagena A, Espinosa M, García-Jiménez R, Jiménez-Rodríguez O, Ponce B, Lora D, Orellana MÁ, Fernández-Ruiz M, Bermejo S, Aguado JM

Urinary tract infections (UTI) are common in emergency departments (ED), and at least 15% of them are bacteremic. However, there are few data on how to predict which patients are at high risk of developing bacteremic UTI (b-UTI). We performed a retrospective observational cohort study including patients diagnosed with UTI who were admitted to the ED of a tertiary-care hospital in Spain. We included only those patients in whom blood cultures were performed. A nomogram for b-UTI was developed as visualizations of a logistic regression model. Two hundred and thirteen patients with UTI were finally included, 108 of them developed b-UTI (50.7%). The mean age was 60.5 ± 21.4 years. A previous urologic disease was present in 45.5%, 12 out of 213 patients (5.6%) had a urologic tumor (10.2% in b-UTI group vs. 1% in non b-UTI, p = 0.003), and 4.2% were kidney transplant recipients. In a multivariate analysis, variables associated with b-UTI were: solid organ malignancy (OR 3.19; CI 95% 1.01-10.03, p = 0.04), elevated neutrophil count (more than 80% of neutrophils) (OR 5.84; CI 95% 2.13-15.99, p = 0.0006), elevated C reactive protein (OR 1.046; CI 95% 1.006-1.087, p = 0.022), and pyuria (presence of ≥50 white cells per high-power field of urine) (OR 4.43; CI 95% 1.94-10.11, p = 0.0004). The presence of solid tumor, elevated neutrophil count, elevated C reactive protein, and pyuria are independent risk factors that could be useful in anticipating the development of bacteremia in patients with UTI seen in the ED.

PMID: 27864665 [PubMed - as supplied by publisher]

Leave a Reply

Your email address will not be published.