Indwelling Urinary Catheter and Dementia Are Associated with Enterococcal Urinary Tract Infections in Hospitalized Patients

Isr Med Assoc J. 2021 Nov;23(11):708-713.

Abstract

Background: The recent increase in enterococcal urinary tract infections (EUTI) and the potential morbidity and mortality associated with inappropriate antimicrobial treatment underscores the need for early risk assessment and institution of appropriate empirical antimicrobial therapy.

Objectives: To identify high-risk features associated with hospitalized patients with EUTI.

Methods: Demographic, clinical, laboratory, and bacteriological data of 285 patients hospitalized with UTI during 2016 were retrieved from the computerized database of Shamir Medical Center. Patients were divided into two groups: EUTI and non-EUTI (NEUTI), according to the presence or absence of enterococcus in the urine culture. The features of the two groups were compared.

Results: We obtained 300 urine cultures from 285 patients. Of the total, 80 patients (26.6%) had EUTI and 220 patients (73.3%) had NEUTI. A higher prevalence of urinary multi-bacterial cultures was found in EUTI compared to NEUTI patients (P < 0.01). Higher prevalence of permanent indwelling urinary catheter and dementia were found in hospitalized patients with community-acquired EUTI and nosocomial EUTI respectively (P = 0.02, P = 0.016) compared to patients with NEUTI.

Conclusions: Indwelling urinary catheter and dementia are risk factors for EUTI in patients with community and hospital acquired infection, respectively.

MeSH terms

  • Aged
  • Anti-Infective Agents / classification
  • Anti-Infective Agents / therapeutic use*
  • Catheters, Indwelling / adverse effects
  • Catheters, Indwelling / microbiology
  • Coinfection / epidemiology
  • Coinfection / microbiology
  • Dementia* / diagnosis
  • Dementia* / epidemiology
  • Enterococcus* / drug effects
  • Enterococcus* / isolation & purification
  • Female
  • Gram-Positive Bacterial Infections* / drug therapy
  • Gram-Positive Bacterial Infections* / etiology
  • Gram-Positive Bacterial Infections* / microbiology
  • Gram-Positive Bacterial Infections* / urine
  • Hospitalization / statistics & numerical data
  • Humans
  • Israel / epidemiology
  • Male
  • Prevalence
  • Risk Assessment / methods*
  • Risk Factors
  • Treatment Outcome
  • Urinary Catheterization* / adverse effects
  • Urinary Catheterization* / methods
  • Urinary Catheters / adverse effects
  • Urinary Catheters / microbiology
  • Urinary Tract Infections* / drug therapy
  • Urinary Tract Infections* / etiology
  • Urinary Tract Infections* / microbiology
  • Urinary Tract Infections* / urine

Substances

  • Anti-Infective Agents