Factors associated with specific uropathogens in catheter-associated urinary tract infection: Developing a clinical prediction model - Abstract

OBJECTIVES: To identify characteristics associated with particular groups of uropathogens in catheter-associated urinary tract infection (CA-UTI) and to develop clinical prediction rules for identifying these groups.

METHODS: Demographic, clinical and microbiological data were analysed from patients with CA-UTI. Infections were categorized into enteric Gram-negative rods, nonfermenters, Gram-positive cocci and fungal. Variables were analysed using univariate and multiple logistic regression analyses, and were used to develop clinical prediction rules.

RESULTS: A total of 492 patients were included in the study. Candida species were the most common uropathogens (30.7%), followed by enterococci (17.3%), Escherichia coli (12.0%), Pseudomonas spp. (10.8%), Klebsiella spp. (7.9%) and staphylococci (6.5%). Clinical prediction rules for the bacterial uropathogenic groups showed poor-to-fair discriminatory power, with sensitivities of < 40% and specificities of >90%. However, clinical prediction rules showed good discriminatory power for fungal infections, with a sensitivity of 67.3% and a specificity of 78.1%.

CONCLUSIONS: Clinical prediction rules developed for identifying specific groups of bacterial uropathogens in patients with CA-UTI had a low sensitivity, whereas those for fungal infections showed good discriminatory power. Further studies to develop more refined and sensitive tools for predicting specific bacterial uropathogens in CA-UTI are warranted.

Written by:
Oh WS, Hur JA, Kim ES, Park KH, Choi HK, Moon C, Kim BN.   Are you the author?
Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Republic of Korea; Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Republic of Korea; Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea; Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea; Department of Internal Medicine, Wonju Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea; Department of Internal Medicine, Inje University Busan-Paik Hospital, Busan, Republic of Korea; Department of Internal Medicine, Inje University Sanggye-Paik Hospital, Seoul, Republic of Korea.  

Reference: J Int Med Res. 2014 Sep 25. pii: 0300060514543035.
doi: 10.1177/0300060514543035


PubMed Abstract
PMID: 25256381

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