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Characteristics of pathogens and mortality predictors of older Chinese patients with nosocomial urinary tract infections
Author(s) -
Hu Wenxue,
Xie Shaoling,
Yu Feng,
Hao Wenke
Publication year - 2019
Publication title -
geriatrics and gerontology international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.823
H-Index - 57
eISSN - 1447-0594
pISSN - 1444-1586
DOI - 10.1111/ggi.13661
Subject(s) - medicine , urinary system , intensive care medicine
Aim The aim of the present study was to investigate predominant pathogens and predictors of 28‐day mortality of older Chinese patients with nosocomial urinary tract infections (NUTI). Methods We retrospectively studied 1122 older patients (aged ≥60 years) with culture‐positive NUTI in Guangdong General Hospital, Guangzhou, China, from January 2009 to December 2014. The clinical features, microbial distributions and outcomes of these patients were recorded and compared between survival and death patients. Multivariate logistic regression was carried out to identify independent predictors of 28‐day mortality. Results The present results showed the all‐cause mortality was 8.3%, and NUTI mortality was 1.43%. The proportions of Candida albicans ( P = 0.004), Acinetobacter baumannii ( P = 0.045) and Candida tropicalis ( P < 0.001) in the death group were significantly higher than those in the survival group. Multivariate analysis showed two novel risk factors for mortality of older patients with NUTI, which were higher Charlson Comorbidity Index (odds ratio [OR] 1.205, 95% confidence interval (CI) 1.088–1.334] and lower level of serum prealbumin (OR 0.995, 95% CI 0.990–0.999). Furthermore, previous use of antibiotics (OR 1.984, 95% CI 1.106–3.559), inappropriate antimicrobial therapy (OR 1.883, 95% CI 1.144–3.098), intensive care unit stay (OR 4.082, 95% CI 2.469–6.749) and higher concentration of serum C‐reactive protein (OR 1.005, 95% CI 1.001–1.010) were independent prognostic factors for 28‐day mortality in older patients with NUTI. Conclusions NUTI is associated with a high 28‐day in‐hospital mortality rate in older patients. We should evaluate the comorbidity, nutritional status, inflammatory markers, department staying and drug sensitivity test, and choose systematic therapy strategies for these older patients with NUTI. Geriatr Gerontol Int 2019; 19: 541–546 .