Table 1.
Basal characteristic, clinical features, empirical antimicrobial treatment and outcomes of included patients and analysis of existing differences between older and non-older patients with a febrile urinary tract infection
| Characteristicsa | All patients (n = 552) | Older (n = 329) | Non-older (n = 223) | P value |
|---|---|---|---|---|
| Baseline conditions | ||||
| Age (years) | 66.1 + 16.7 | 77.3 + 7.6 | 49.5 + 12.2 | < 0.001 |
| HCA-FUTI | 203 (36.8) | 177 (53.8) | 26 (11.7)s | < 0.001 |
| Previous hospital admission | 130 (23.6) | 114 (34.7) | 16 (7.2) | < 0.001 |
| Long term care facility | 46 (8.3) | 43 (13.1) | 3 (1.3) | < 0.001 |
| IV home-day hospital treatment | 13 (2.4) | 9 (2.7) | 4 (1.8) | 0.47 |
| Specialized nursing care | 7 (1.3) | 6 (1.8) | 1 (0.4) | 0.25 |
| Indwelling urinary catheter | 76 (13.8) | 66 (20.1) | 10 (4.5) | < 0.001 |
| Long-term IUC | 40 (7.2) | 33 (10) | 7 (3.1) | 0.002 |
| Short- term IUC | 36 (6.5) | 33 (10) | 3 (1.3) | < 0.001 |
| Invasive urinary intrumentation | 110 (19.9) | 98 (29.8) | 12 (5.4) | < 0.001 |
| Dementia | 64 (11.6) | 62 (18.8) | 2 (0.9) | < 0.001 |
| Diabetes mellitus | 148 (26.8) | 113 (34.3) | 35 (15.7) | < 0.001 |
| Chronic kidney failure | 54 (9.8) | 49 (14.9) | 5 (2.2) | < 0.001 |
| Cirrhosis | 9 (1.6) | 5 (1.5) | 4 (1.8) | 1 |
| Neoplasia | 81 (14.7) | 72 (21.9) | 9 (4) | < 0.001 |
| Heart failure | 8 (1.4) | 7 (2.1) | 1 (0.4) | 0.15 |
| Chronic obstructive lung disease | 100 (18.1) | 90 (27.4) | 10 (4.5) | < 0.01 |
| Immunosuppressive or corticosteroid treatment | 11 (2) | 7 (2.1) | 4 (1.8) | 1 |
| Charlson score | 3.6 + 2.5 | 5.1 + 1.7 | 1.3 + 1.6 | < 0.001 |
| Previous UTI | 222 (45.5) | 152 (53.7) | 70 (34.1) | < 0.001 |
| Urinary tract abnormality | 339 (61.5) | 252 (76.8) | 87 (39) | < 0.001 |
| BPH | 239 (43.4) | 187 (57) | 52 (23.3) | < 0.001 |
| Urogenital cancer | 48 (8.8) | 44 (13.6) | 4 (1.8) | < 0.001 |
| Previous antibiotic treatment | 179 (32.6) | 135 (41.3) | 44 (19.8) | < 0.001 |
| Aminopenicillins | 60 (11) | 42 (13) | 18 (8.2) | 0.081 |
| Fluoroquinolones | 54 (9.9) | 41 (12.7) | 13 (5.9) | 0.010 |
| TGC | 16 (2.9) | 11 (3.4) | 5 (2.3) | 0.44 |
| Fosfomycine | 10 (1.8) | 9 (2.8) | 1 (0.5) | 0.055 |
| Clinical presentation | ||||
| LUTS | 359 (65.3) | 172 (52.4) | 187 (84.2) | < 0.001 |
| Flank pain | 89 (16.2) | 31 (9.5) | 58 (26.1) | < 0.001 |
| Physical examination | ||||
| Temperature | 37.7 + 1 | 37.7 + 1.1 | 37.7 + 0.9 | 0.85 |
| MAP (mmHg) | 93.4 + 15.3 | 91.1 + 15.3 | 96.9 + 14.7 | < 0.001 |
| Lumbar tenderness | 94 (22.1) | 40 (17.3) | 54 (27.7) | 0.010 |
| Prostatic tenderness | 81 (42.6) | 35 (37.2) | 46 (47.9) | 0.13 |
| Laboratory | ||||
| WBC count (leukocytes/mm3) | 13,903 + 5743 | 13,348 + 5536 | 14,759 + 5961 | 0.006 |
| Creatinine (mg/dl) | 1.2 + 0.7 | 1.4 + 0.8 | 1.1 + 0.4 | < 0.010 |
| Bacteremia | 120 (31.6) | 92 (38) | 28 (20.3) | < 0.010 |
| Treatment | ||||
| Empirical treatment with TGC | 307 (55.6) | 176 (53.5) | 131 (58.7) | 0.22 |
| Empirical treatment with carbapenems or PT | 59 (10.7) | 46 (14) | 13 (5.8) | 0.002 |
| IEAT | 95 (17.2) | 69 (21) | 26 (11.7) | 0.004 |
| OPAT | 71 (12.9) | 54 (16.4) | 17 (7.6) | 0.002 |
| Outcomes | ||||
| Severe sepsis or septic shock | 17 (3.1) | 12 (3.6) | 5 (2.2) | 0.35 |
| Hospital admission | 266 (48.2) | 197 (59.9) | 69 (30.9) | < 0.001 |
| Length of hospitalisation (days) | 2.6 + 4.1 | 3.3 + 4.6 | 1.4 + 2.9 | < 0.001 |
| Length antimicrobial therapy (days) | 16.3 + 6.7 | 16 + 7 | 16.8 + 6.5 | 0.19 |
| All-cause in-hospital mortality | 15 (2.7) | 14 (4.3) | 1 (0.4) | 0.007 |
| Attributable in-hospital mortality | 8 (1.4) | 8 (2.4) | 0 | 0.024 |
Abbreviations: BPH Benign prostatic hyperplasia, HCA-FUTI Healthcare-associated febrile urinary tract infection, IEAT Inadequate empirical antimicrobial treatment, IUC Indwelling urinary catheter, LUTS Lower urinary tract symptoms, MAP Mean arterial pressure, OPAT Outpatient parenteral antimicrobial therapy, PT Piperacillin-tazobactam, TGC Third-generation cephalosporins, UTI Urinary tract infections, WBC White blood cell
aData presented as mean + standard deviation (SD) or numbers of patients (percentages)