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Community-acquired urosepsis

Abstract number: R2523

Naz H., Cevik F., Aykin N., Ozakin E.

Objectives: Community acquired urinary tract infections (CAUTI) are among the most common bacterial infections. In our study we aimed to analyse retrospectively, the cases we followed in our clinic, diagnosed as CAUTI, and to share the risk factors, clinic, ethiologic and laboratory data in cases with urosepsis(US).

Methods: The cases followed in Eski[scedil]ehir Yunus Emre State Hospital, Department of Infectious Diseases, during January 2005 and October 2007, diagnosed as CAUTI were analysed retrospectively. The Chi-squared test was used for qualitative variables and independent predictors of US were assessed using multiple logistic regression.

Results: 229 UTI and 71 (31%) US cases were determined during the study period. Between the US cases, 43 (60.6%) were women, 28 (39.4%) were men, with a mean age of 67.4+ 15.9 (20–92) years. The distribution of the US cases was: sepsis 65 (90.1%); severe sepsis 5 (7%); septic shock 1(1.4%), multiple organ disfunction 1 (1.4%). When the cases with and without US were compared, leucocytosis, thrombocytopenia, elevated sedimentation rate, elevated CRP, pyuria, haematuria, proteinuria and leucocyte esterase positiveness was significantly higher in the US cases. When the risk factors of the 229 CAUTI cases were compared according to the presence of US, age (year), diabetes mellitus (DM), neurologic disease, chronic obstructive pulmonary disease (COPD), steroid therapy, and immunosupression were statistically significantly higher in patients with US (table-1). The most frequent microorganism encountered by blood and urinary cultures, in patients followed for CAUTI, with or without US, was E. coli, Klebsiella sp. and Enterococcus sp. In one case it was polymicrobial. 6 of the 71 patients with US died, (mortality rate 8.5%). Of the 158 cases without US, one patient died (mortality rate 0.6%). The mortality in cases with US was statistically significantly higher (p = 0.001).

Conclusion: The CAUTI cases that are elderly, have other diseases such as DM, COPD, neurologic diseases and have received steroid therapy or immunosupression, have a higher risk of developing US. Although ratios may vary, the causative agents are not different in community acquired US cases and in the cases without.

Table 1. Comparison of the risk factors according to US

Session Details

Date: 19/04/2008
Time: 00:00-00:00
Session name: 18th European Congress of Clinical Microbiology and Infectious Diseases
Subject:
Location: Barcelona, Spain
Presentation type:
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