caa a22 4500 606156232 CHVBK 20210128100607.0 cr unu---uuuuu 210128e20151201xx s 000 0 eng 10.1007/s10096-015-2493-8 doi (NATIONALLICENCE)springer-10.1007/s10096-015-2493-8 Differential characteristics of healthcare-associated compared to community-acquired febrile urinary tract infections in males [Elektronische Daten] [A. Smithson, J. Ramos, M. Bastida, S. Bernal, N. Jove, E. Niño, N. Msabri, R. Porrón] The objective of this study was to analyse the characteristics of healthcare-associated febrile urinary tract infection (HCA-FUTI) compared to community-acquired FUTI (CA-FUTI) in men. An ambispective cross-sectional study in which we recorded clinical and microbiology data and outcomes from males with FUTI attended in the Emergency Department was carried out. A total of 479 males with FUTI, 162 (33.8%) HCA-FUTI and 317 (66.2%) CA-FUTI, were included. HCA-FUTI patients were older (p < 0.001), had higher Charlson scores (p < 0.001) and received previous antimicrobial treatment more frequently (p < 0.001) compared to CA-FUTI patients. HCA-FUTI was less likely caused by Escherichia coli (p < 0.001) and more frequently by Klebsiella spp. (p = 0.02), Enterobacter spp. (p < 0.001) and Pseudomonas aeruginosa (p < 0.001). Resistance to ceftriaxone (p = 0.006), gentamicin (p < 0.001), quinolones (p < 0.001), co-trimoxazole (p = 0.001) and fosfomycin (p = 0.009) was higher among E. coli strains isolated from males with HCA-FUTI and so was the prevalence of extended-spectrum beta-lactamase and AmpC E. coli and Klebsiella spp.-producing strains (p = 0.012). Inadequate antimicrobial treatment and all-cause in-hospital mortality was associated with HCA-FUTI (p < 0.001 and p = 0.004, respectively). Independent factors for mortality were severe sepsis or septic shock [odds ratio (OR) 29; 95% confidence interval (CI): 3.9-214] and cirrhosis (OR 23.7; 95% CI: 1.6-350.6). Male patients with HCA-FUTI have different clinical characteristics, outcomes and microbiological features compared to CA-FUTI patients. Previous contact with the healthcare system has to be taken into consideration when deciding the optimal antimicrobial treatment in males with FUTI. Springer-Verlag Berlin Heidelberg, 2015 Smithson A. Infectious Diseases Unit, Fundació Hospital de l'Esperit Sant, C/Avinguda Mossen Pons i Rabadà s/n, 08923, Santa Coloma de Gramenet, Barcelona, Spain aut Ramos J. Internal Medicine Department, Fundació Hospital de l'Esperit Sant, Santa Coloma de Gramenet, Barcelona, Spain aut Bastida M. Microbiology Laboratory, Fundació Hospital de l'Esperit Sant, Santa Coloma de Gramenet, Barcelona, Spain aut Bernal S. Urology Department, Fundació Hospital de l'Esperit Sant, Santa Coloma de Gramenet, Barcelona, Spain aut Jove N. Internal Medicine Department, Fundació Hospital de l'Esperit Sant, Santa Coloma de Gramenet, Barcelona, Spain aut Niño E. Internal Medicine Department, Fundació Hospital de l'Esperit Sant, Santa Coloma de Gramenet, Barcelona, Spain aut Msabri N. Internal Medicine Department, Fundació Hospital de l'Esperit Sant, Santa Coloma de Gramenet, Barcelona, Spain aut Porrón R. Infectious Diseases Unit, Fundació Hospital de l'Esperit Sant, C/Avinguda Mossen Pons i Rabadà s/n, 08923, Santa Coloma de Gramenet, Barcelona, Spain aut European Journal of Clinical Microbiology & Infectious Diseases Springer Berlin Heidelberg 34/12(2015-12-01), 2395-2402 0934-9723 34:12<2395 2015 34 10096 https://doi.org/10.1007/s10096-015-2493-8 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s10096-015-2493-8 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Smithson A. Infectious Diseases Unit, Fundació Hospital de l'Esperit Sant, C/Avinguda Mossen Pons i Rabadà s/n, 08923, Santa Coloma de Gramenet, Barcelona, Spain aut NATIONALLICENCE 700 1- Ramos J. Internal Medicine Department, Fundació Hospital de l'Esperit Sant, Santa Coloma de Gramenet, Barcelona, Spain aut NATIONALLICENCE 700 1- Bastida M. Microbiology Laboratory, Fundació Hospital de l'Esperit Sant, Santa Coloma de Gramenet, Barcelona, Spain aut NATIONALLICENCE 700 1- Bernal S. Urology Department, Fundació Hospital de l'Esperit Sant, Santa Coloma de Gramenet, Barcelona, Spain aut NATIONALLICENCE 700 1- Jove N. Internal Medicine Department, Fundació Hospital de l'Esperit Sant, Santa Coloma de Gramenet, Barcelona, Spain aut NATIONALLICENCE 700 1- Niño E. Internal Medicine Department, Fundació Hospital de l'Esperit Sant, Santa Coloma de Gramenet, Barcelona, Spain aut NATIONALLICENCE 700 1- Msabri N. Internal Medicine Department, Fundació Hospital de l'Esperit Sant, Santa Coloma de Gramenet, Barcelona, Spain aut NATIONALLICENCE 700 1- Porrón R. Infectious Diseases Unit, Fundació Hospital de l'Esperit Sant, C/Avinguda Mossen Pons i Rabadà s/n, 08923, Santa Coloma de Gramenet, Barcelona, Spain aut NATIONALLICENCE 773 0- European Journal of Clinical Microbiology & Infectious Diseases Springer Berlin Heidelberg 34/12(2015-12-01), 2395-2402 0934-9723 34:12<2395 2015 34 10096