Urinary tract infection (UTI) is a common condition that predominantly affects elderly people, who are particularly susceptible to developing sepsis. Previous studies have indicated a detrimental effect of sepsis on short-term outcomes in elderly patients with UTI, but there is a lack of data about the middle-term prognosis. The aim of this study was to investigate the influence of sepsis on the middle-term prognosis of patients aged 65 years or older with complicated community-acquired UTIs. A prospective observational study of patients admitted to a hospital with UTI. We conducted a comparison of epidemiological and clinical variables between septic and nonseptic patients with UTI, as well as their 6-month case-fatality rate. A total of 412 cases were included, 47.8% of them with sepsis. Septic patients were older (83 vs. 80 years, < 0.001), but did not have more comorbidities. The short-term case-fatality rate was higher in septic patients and this difference persisted at 6 months (34% vs. 18.6%, = 0.003). Furthermore, age older than 75 years, Barthel index <40 and healthcare-associated UTI were also associated with the middle-term case-fatality rate. In conclusion, the detrimental impact of sepsis is maintained on the middle-term prognosis of elderly patients with UTI. Age, functional status and healthcare-associated UTIs also play significant roles in shaping patient outcomes.
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http://dx.doi.org/10.3390/microorganisms11081959 | DOI Listing |
Mater Today Bio
February 2025
Scientific Research Center, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, 518107, China.
Sepsis is a serious and life-threatening condition, which can lead to organ failure and death clinically. Abnormally increased cell-free DNA (cfDNA) and inflammatory cytokines are involved in the development and progression of sepsis. Thus, cfDNA clearance and down-regulation of inflammatory factors are essential for the effective treatment of sepsis.
View Article and Find Full Text PDFFournier's gangrene is a grave necrotizing fasciitis that primarily affects the perineum, spreading through the fascias and leading to significant tissue destruction. The involvement of the urethra in necrosis is extremely rare, if not anecdotal. Emphysematous pyelonephritis, is a urinary infection with a high risk of progression to sepsis.
View Article and Find Full Text PDFHeliyon
January 2025
Department of Emergency Medicine, Seoul National University Bundang Hospital (SNUBH), Seongnam-si, South Korea.
Background: Development of acute kidney injury (AKI) in patients with sepsis is associated with increased mortality, highlighting the importance of early detection and management. However, baseline creatinine or urine output measurements are required for AKI diagnosis, which can be challenging in emergency departments (EDs). We aimed to evaluate the association between urinary biomarkers and the AKI diagnosis or 30-day survival status in patients with sepsis in the ED.
View Article and Find Full Text PDFAm J Physiol Endocrinol Metab
January 2025
Department of Microbiology, Immunology, & Cell Biology, West Virginia University School of Medicine, 64 Medical Center Drive, Morgantown, WV, 26506, USA.
Human neonates are predisposed to an increased risk of mortality from infection due to fundamental differences in the framework of innate and adaptive immune responses relative to those in the adult population. As one key difference in neonates, an increase in the immunosuppressive cytokine, IL-27, is responsible for poor outcomes in a murine neonatal model of bacterial sepsis. In our model, the absence of IL-27 signaling during infection is associated with improved maintenance of body mass, increased bacterial clearance with reduced systemic inflammation, and decreased mortality rates that correlate to preservation of glucose homeostasis and insulin production.
View Article and Find Full Text PDFAm J Trop Med Hyg
January 2025
Department of Microbiology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, India.
Melioidosis is a neglected tropical infection caused by the Gram-negative bacterium Burkholderia pseudomallei, which is found in soil and water across tropical countries. The infection spectrum ranges from mild localized lesions to severe sepsis. The clinical presentation, severity, and outcome are influenced by the route of infection, bacterial load, strain virulence, and specific virulence genes of B.
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