Katater İlişkili Üriner Sistem Enfeksiyonlarında Mortalite ile İlişkili Faktörlerin Değerlendirilmesi: 5 Yıllık Retrosepektif Çalışma

Abstract

Objective: The aim of the study is to evaluate the relationship between mortality and epidemiological factors, comorbid conditions, antibiotic resistance, empirical antimicrobial therapy, and laboratory parameters in catheter-associated urinary tract infections (CAUTI). Materials and Methods: A retrospective cohort study was designed in patients aged ≥18 years admitted to intensive care unit between 1st Jan 2015 and 1st Jan 2020. The primary endpoint was death within the first 28 days of admission, while the secondary endpoint was survival after 28 days. p value <0.05 was considered statistically significant. Results: A total of 375 patients with a median age of 78 were included in the study; 198 (52.8%) were female. The most commonly detected microorganisms were Escherichia coli (50.9%) and Enterococcus faecalis (16.8%). Resistance to third generation cephalosporin, ciprofloxacin, and meropenem was found in 41.3%, 40%, and 8.6% of Gram-negative bacteria, respectively. Vancomycin resistance was detected in 0.3% of the Gram-positive bacteria. The mortality rate was 58.1%. Factors associated with an increased risk of mortality were age ≥65 years, presence of malignancy, mechanical ventilation, APACHE II score ≥20, and a diagnosis of septic shock. The only factor associated with the lower mortality risk was the detection of E. coli in culture. Conclusion: It was determined that aging, malignancy, clinical scoring systems and microbiological results had an effect on mortality. Considering the results of this study together with the infection control measures, and treatment recommendations in the guidelines, we think that mortality due to CAUTI can be reduced.