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Pseudomonas aeruginosa urinary tract infections in hospitalized patients:
Mortality and prognostic factors
#MMPMID28552972
Lamas Ferreiro JL
; Álvarez Otero J
; González González L
; Novoa Lamazares L
; Arca Blanco A
; Bermúdez Sanjurjo JR
; Rodríguez Conde I
; Fernández Soneira M
; de la Fuente Aguado J
PLoS One
2017[]; 12
(5
): e0178178
PMID28552972
show ga
BACKGROUND: The aim of this study was to analyze the mortality and predictors of
30-day mortality among hospitalized patients with Pseudomonas aeruginosa urinary
tract infection (PAUTI) and the impact of antibiotic treatment on survival.
METHODS: Patients admitted to our hospital with PAUTI or those diagnosed of PAUTI
during hospitalization for other disease between September 2012 and September
2014 were included. Repeated episodes from the same patient were excluded.
Database with demographic, clinical and laboratory ítems was created. Empirical
and definitive antibiotic therapy, antimicrobial resistance and all-cause
mortality at 30 and 90 days were included. RESULTS: 62 patients were included,
with a mean age of 75 years. 51% were male. Mortality was 17.7% at 30 days and
33.9% at 90 days. Factors associated with reduced survival at 30 days were
chronic liver disease with portal hypertension (P<0,01), diabetes mellitus (P =
0,04) chronic renal failure (P = 0,02), severe sepsis or septic shock (P<0,01),
Charlson index > 3 (P = 0.02) and inadequated definitive antibiotic treatment
(P<0,01). Independent risk factors for mortality in multivariate analysis were
advanced chronic liver disease (HR 77,4; P<0,01), diabetes mellitus (HR 3,6; P =
0,04), chronic renal failure (HR 4,1; P = 0,03) and inadequated definitive
antimicrobial treatment (HR 6,8; P = 0,01). CONCLUSIONS: PAUTI are associated
with high mortality in hospitalized patients, which increases significantly in
those with severe comorbidity such as chronic renal failure, advanced liver
disease or diabetes mellitus. Inadequated antibiotic treatment is associated with
poor outcome, which remarks the importance of adjusting empirical antibiotic
treatment based on the microbiological susceptibility results.
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