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Risk factors can help predict which patients with hospital-acquired urinary tract infections will develop blood infections

Urinary tract infection (UTI) is the most frequent type of hospital-acquired (nosocomial) infection in the United States, and is usually related to use of urinary catheters. Some patients who develop UTIs eventually develop blood infections (bacteremia), and 1 in 10 of these patients die within a week.

A new study reveals several factors that place patients with UTIs at risk of developing bacteremia. Patients who had undergone immuno-suppressant therapy within 14 days of developing the UTI were over 8 times as likely to develop a blood infection. Men and patients with a history of cancer were nearly twice as likely to develop a blood infection.

In addition, patients who had smoked cigarettes in the past 5 years were 26 percent more likely, but those who had used antibiotics within 3 days of developing a UTI were 24 percent less likely to develop a blood infection.

Finally, among patients who were younger than 70 years, those who had used corticosteroids within 7 days of a UTI (which may lower resistance to infection) were over 14 times more likely and those who had diabetes (which increases susceptibility to infection) were over 6 times more likely to develop a blood infection.

Knowing these risk factors could help clinicians target high-risk individuals for specific interventions to decrease their risk of blood infections from UTIs, notes Sanjay Saint, M.D., M.P.H., of the University of Michigan. Dr. Saint and colleagues examined 95 case patients and 142 control patients with UTIs, who were hospitalized within a Veterans Affairs health care system between 1984 and 1999.

The case patients had a urine culture and a blood culture that grew the same bacterium within 48 or more hours after hospital admission, and the control patients did not have a positive blood culture (no bacteremia). The study was supported in part by the Agency for Healthcare Research and Quality (HS11540).

See "Risk factors for nosocomial urinary tract-related bacteremia: A case-control study," by Dr. Saint, Samuel R. Kaufman, M.A., Mary A.M. Rogers, Ph.D., and others, in the September 2006 American Journal of Infection Control 34(7), pp. 401-407.

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