Predictors of hospital-acquired urinary tract-related bloodstream infection.
Predictors of hospital-acquired urinary tract-related bloodstream infection.
复制标题
医院获得性尿路相关血流感染的预测因素。
DOI：
10.1086/667731
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发表时间：
2012-10
影响因子：
4.5
通讯作者：
Saint S
中科院分区：
文献类型：
--
作者：
Greene MT;Chang R;Kuhn L;Rogers MA;Chenoweth CE;Shuman E;Saint S
Bloodstream infection (BSI) secondary to nosocomial urinary tract infection (UTI) is associated with substantial morbidity, mortality and additional financial costs. Our objective was to identify predictors of nosocomial urinary tract-related BSI. Matched case-control study. Midwestern tertiary care hospital. Cases (n = 298) were patients with a positive urine culture obtained > 48 hours after admission and a blood culture obtained within 14 days of the urine culture which grew the same organism. Controls (n = 667), selected by incidence density sampling, included patients with a positive urine culture who were at risk for BSI but did not develop one. Conditional logistic regression and classification and regression tree (CART) analyses. The most frequently isolated microorganisms which spread from the urinary tract to the bloodstream were Enterococcus sp. Independent risk factors included neutropenia (OR = 10.99, 95% CI: 5.78–20.88), renal disease (OR = 2.96, 95% CI: 1.98–4.41) and male sex (OR = 2.18, 95% CI: 1.52–3.12). The probability of developing a urinary tract-related BSI among neutropenic patients was 70%. Receipt of immunosuppressants (OR = 1.53, 95% CI: 1.04–2.25), insulin (OR=4.82, 95% CI: 2.52–9.21) and antibacterials (OR = 0.66, 95% CI: 0.44–0.97) also significantly altered risk. The heightened risk of urinary tract-related BSI associated with several comorbid conditions suggests that the management of nosocomial bacteriuria may benefit from tailoring to certain patient subgroups. Consideration of time-dependent risk factors such as medications may also help guide clinical decisions in reducing BSI.
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影响因子：
19.6
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