AI Article Synopsis
- - The study aimed to identify risk factors for complicated Enterococcus faecalis urinary tract infections (UTIs) in older patients, as these are not well understood, involving a cohort of 659 patients admitted to the hospital.
- - Results showed that 13.2% of patients had E. faecalis UTI, with a significant proportion experiencing severe sepsis and a higher incidence of inadequate antibiotic treatment compared to Gram-negative UTIs.
- - The authors concluded that elderly patients with urinary catheters or previous urinary tract procedures should receive empirical treatment for E. faecalis to reduce the risk of ineffective antibiotic therapy.
Article Abstract
Aim: Risk factors for complicated community acquired Enterococcus faecalis urinary tract infection (UTI) in older patients are not well known.
Methods: We identified the predictive factors for E. faecalis on a cohort of 659 older patients admitted to hospital with complicated UTI. We also examined the adequacy of empirical antimicrobial therapy and outcomes in E. faecalis UTI. Multivariable logistic regression was used to identify predictors of E. faecalis UTI.
Results: A total of 87 (13.2%) patients had E. faecalis UTI; of these 63.2% were men, their mean age was 82.3 years and they had a great number of comorbidities. Severe sepsis or septic shock was present in 50.5%, and bacteremia was present in 26%. Indwelling urinary catheter and previous urinary instrumentation were risk factors for E. faecalis UTI by multivariate analysis (OR 2.05; 95% CI 1.15-3.65 and OR 2.16; 95% CI 1.08-4.34, respectively). Inadequate empirical antimicrobial therapy was higher in E. faecalis UTI than in UTI caused by Gram-negative microorganisms (66.6% vs 19%, P < 0.001). No significant differences in length of hospital stay or mortality were noted between E. faecalis and Gram-negative UTI.
Conclusions: In older patients admitted to hospital with complicated community-acquired UTI, E. faecalis should be considered for empirical treatment if the patient has a urinary catheter or previous urinary tract instrumentation in order to avoid inadequate empirical antibiotic therapy. Geriatr Gerontol Int 2019; ••: ••-••.
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| http://dx.doi.org/10.1111/ggi.13856 | DOI Listing |
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