Demography and burden of care associated with patients readmitted for urinary tract infection.

Background: Urinary tract infection (UTI) is one of the most prevalent admission diagnoses in hospital-based clinical practice. Despite its frequency, few data are available regarding its demographics and economic implications.

Purpose: To describe the demography, epidemiology, and burden of care of patients admitted to hospital with UTI and compare these characteristics depending on admission status.

Methods: A retrospective cohort study using an administrative database of patients admitted to Hartford Hospital (September 2011-August 2012) with UTI. Patient demographics, hospital characteristics, and total costs of care were examined.

Results: A total of 2345 unique patients were included. The mean age of the patients was 78 years and 71% were female. Median length of stay and total cost were 5 days and $8326 (interquartile range $5388-$14,179), respectively. A total of 359 patients (16.4%) were readmitted within 30 days, of which 111 patients (5.1%) had UTI on readmission. Only 16.3% of readmitted patients were infected with the same causative pathogen. A significant increase in the incidence of Enterococcus faecalis (1.2% vs. 9.3%; p = 0.046) occurred upon readmission, whereas occurrence of Enterobacteriaceae infection decreased in the readmission group (50.0% vs. 25.6%; p = 0.006), including a lower proportion of Escherichia coli (32.5% vs. 11.6%; p < 0.001). A higher proportion of readmission pathogens were nonsusceptible, including significant changes to cefazolin (24.4% vs. 63.6%; p = 0.004) and cefepime (8.7% vs. 27.6; p = 0.05).

Conclusion: UTI is highly prevalent and is associated with significant utilization of health-care resources among hospitalized patients. These findings, coupled with considerable rates of 30-day readmission, stress the importance of proper diagnosis and treatment.