Skip to main content

Advertisement

SpringerLink
Log in

Risk factors for enterococcal urinary tract infections: a multinational, retrospective cohort study

  • Brief Report
  • Published:
European Journal of Clinical Microbiology & Infectious Diseases Aims and scope Submit manuscript

Abstract

Complicated urinary tract infection (cUTI) is a frequent cause of morbidity. In this multinational retrospective cohort study, we aimed to demonstrate risk factors for enterococcal UTI. Univariate and multivariate analyses of risk factors for enterococcal infection were performed. Among 791 hospitalized patients with cUTI, enterococci accounted for approximately 10% of cases (78/791). Risk factors for enterococcal UTI in multivariable analysis were male gender, age range of 55–75 years, catheter-associated UTI, and urinary retention. This information may assist treating physicians in their decision-making on prescribing empiric anti-enterococcus treatment to hospitalized patients presenting with cUTI and thus improve clinical outcomes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Code availability

Not applicable

References

  1. Czaja CA, Scholes D, Hooton TM, Stamm WE (2007) Population-based epidemiologic analysis of acute pyelonephritis. Clin Infect Dis Off Publ Infect Dis Soc Am 45(3):273–280. https://doi.org/10.1086/519268

    Article  Google Scholar 

  2. Giannakopoulos X, Sakkas H, Ragos V et al (2019) Impact of enterococcal urinary tract infections in immunocompromised - neoplastic patients. J BUON 24(5):1768–1775

    PubMed  Google Scholar 

  3. Flores-Mireles AL, Walker JN, Caparon M, Hultgren SJ (2015) Urinary tract infections: epidemiology, mechanisms of infection and treatment options. Nat Rev Microbiol 13(5):269–284. https://doi.org/10.1038/nrmicro3432

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Levison ME, Kaye D (2013) Treatment of complicated urinary tract infections with an emphasis on drug-resistant gram-negative uropathogens. Curr Infect Dis Rep 15(2):109–115. https://doi.org/10.1007/s11908-013-0315-7

    Article  PubMed  Google Scholar 

  5. Fisher JF, Kavanagh K, Sobel JD, Kauffman CA, Newman CA (2011) Candida urinary tract infection: pathogenesis. Clin Infect Dis Off Publ Infect Dis Soc Am 52(Suppl 6):S437–S451. https://doi.org/10.1093/cid/cir110

    Article  Google Scholar 

  6. Chen YH, Ko WC, Hsueh PR (2013) Emerging resistance problems and future perspectives in pharmacotherapy for complicated urinary tract infections. Expert Opin Pharmacother 14(5):587–596. https://doi.org/10.1517/14656566.2013.778827

    Article  CAS  PubMed  Google Scholar 

  7. Jacobsen SM, Stickler DJ, Mobley HLT, Shirtliff ME (2008) Complicated catheter-associated urinary tract infections due to Escherichia coli and Proteus mirabilis. Clin Microbiol Rev 21(1):26–59. https://doi.org/10.1128/CMR.00019-07

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Maki DG, Tambyah PA (2001) Engineering out the risk for infection with urinary catheters. Emerg Infect Dis 7(2):342–347. https://doi.org/10.3201/eid0702.010240

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Ramsey AM, Zilberberg MD (2009) Secular trends of hospitalization with vancomycin-resistant enterococcus infection in the United States, 2000-2006. Infect Control Hosp Epidemiol 30(2):184–186. https://doi.org/10.1086/593956

    Article  PubMed  Google Scholar 

  10. Agudelo Higuita NI, Huycke MM (2014) Enterococcal Disease, Epidemiology, and Implications for Treatment. In: Gilmore MS, Clewell DB, Ike Y, Shankar N, eds. Enterococci: From Commensals to Leading Causes of Drug Resistant Infection. Massachusetts Eye and Ear Infirmary. http://www.ncbi.nlm.nih.gov/books/NBK190429/. Accessed 28 Dec 2019

  11. Data from the ECDC Surveillance Atlas - Antimicrobial resistance. European Centre for Disease Prevention and Control. https://www.ecdc.europa.eu/en/antimicrobial-resistance/surveillance-and-disease-data/data-ecdc. Accessed 5 June 2020

  12. Noskin GA, Peterson LR, Warren JR (1995) Enterococcus faecium and Enterococcus faecalis bacteremia: acquisition and outcome. Clin Infect Dis 20:296–301. https://doi.org/10.1093/clinids/20.2.296

    Article  CAS  PubMed  Google Scholar 

  13. Patterson JE, Sweeney AH, Simms M, Carley N, Mangi R, Sabetta J, Lyons RW (1995) An analysis of 110 serious enterococcal infections. Epidemiology, antibiotic susceptibility, and outcome. Medicine (Baltimore) 74:191–200. https://doi.org/10.1097/00005792-199507000-00003

    Article  CAS  Google Scholar 

  14. McBride SJ, Upton A, Roberts SA (2010) Clinical characteristics and outcomes of patients with vancomycin-susceptible Enterococcus faecalis and Enterococcus faecium bacteraemia--a five-year retrospective review. Eur J Clin Microbiol Infect Dis 29:107–114. https://doi.org/10.1007/s10096-009-0830-5

    Article  CAS  PubMed  Google Scholar 

  15. Garrison RN, Fry DE, Berberich S, Polk HC (1982) Enterococcal bacteremia: clinical implications and determinants of death. Ann Surg 196:43–47. https://doi.org/10.1097/00000658-198207000-00010

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Gray J, Marsh PJ, Stewart D, Pedler SJ (1994) Enterococcal bacteraemia: a prospective study of 125 episodes. J Hosp Infect 27:179–186. https://doi.org/10.1016/0195-6701(94)90125-2

    Article  CAS  PubMed  Google Scholar 

  17. Graninger W, Ragette R (1992) Nosocomial bacteremia due to Enterococcus faecalis without endocarditis. Clin Infect Dis 15:49–57. https://doi.org/10.1093/clinids/15.1.49

    Article  CAS  PubMed  Google Scholar 

  18. Eliakim-Raz N, Babitch T, Shaw E et al (2019) Risk factors for treatment failure and mortality among hospitalized patients with complicated urinary tract infection: a multicenter retrospective cohort study (RESCUING Study Group). Clin Infect Dis 68(1):29–36. https://doi.org/10.1093/cid/ciy418

    Article  PubMed  Google Scholar 

  19. Jombo GT, Emanghe UE, Amefule EN, Damen JG (2011) Urinary tract infections at a Nigerian university hospital: Causes, patterns and antimicrobial susceptibility profile. J Microbiol Antimicrob 3(6):153–159

    Google Scholar 

  20. Mathai D, Jones RN, Pfaller MA (2001) SENTRY Participant Group North America. Epidemiology and frequency of resistance among pathogens causing urinary tract infections in 1,510 hospitalized patients: a report from the SENTRY Antimicrobial Surveillance Program (North America). Diagn Microbiol Infect Dis 40(3):129–136. https://doi.org/10.1016/s0732-8893(01)00254-1

    Article  CAS  PubMed  Google Scholar 

  21. Bouza E, San Juan R, Muñoz P, Voss A, Kluytmans J (2001) Co-operative group of the european study group on nosocomial infections. A European perspective on nosocomial urinary tract infections I. Report on the microbiology workload, etiology and antimicrobial susceptibility (ESGNI-003 study). European Study Group on Nosocomial Infections. Clin Microbiol Infect 7(10):523–531. https://doi.org/10.1046/j.1198-743x.2001.00326.x

    Article  CAS  PubMed  Google Scholar 

  22. Bouza E, San Juan R, Muñoz P, Voss A, Kluytmans J (2001) Co-operative group of the european study group on nosocomial infections. A European perspective on nosocomial urinary tract infections II. Report on incidence, clinical characteristics and outcome (ESGNI-004 study). European Study Group on Nosocomial Infection. Clin Microbiol Infect 7(10):532–542. https://doi.org/10.1046/j.1198-743x.2001.00324.x

    Article  CAS  PubMed  Google Scholar 

  23. Madrazo M, Esparcia A, Alberola J et al (2020) Predictive factors for Enterococcus faecalis in complicated community-acquired urinary tract infections in older patients. Geriatr Gerontol Int 20(3):183–186. https://doi.org/10.1111/ggi.13856

    Article  PubMed  Google Scholar 

  24. Kajihara T, Nakamura S, Iwanaga N et al (2015) Clinical characteristics and risk factors of enterococcal infections in Nagasaki, Japan: a retrospective study. BMC Infect Dis 15. https://doi.org/10.1186/s12879-015-1175-6

  25. Pinholt M, Ostergaard C, Arpi M et al (2014) Incidence, clinical characteristics and 30-day mortality of enterococcal bacteraemia in Denmark 2006-2009: a population-based cohort study. Clin Microbiol Infect Off Publ Eur Soc Clin Microbiol Infect Dis 20(2):145–151. https://doi.org/10.1111/1469-0691.12236

    Article  CAS  Google Scholar 

  26. Billington EO, Phang SH, Gregson DB et al (2014) Incidence, risk factors, and outcomes for Enterococcus spp. blood stream infections: a population-based study. Int J Infect Dis IJID Off Publ Int Soc Infect Dis 26:76–82. https://doi.org/10.1016/j.ijid.2014.02.012

    Article  CAS  Google Scholar 

  27. Saia RS, Garcia FM, Cárnio EC (2015) Estradiol protects female rats against sepsis induced by Enterococcus faecalis improving leukocyte bactericidal activity. Steroids. 102:17–26. https://doi.org/10.1016/j.steroids.2015.06.016

    Article  CAS  PubMed  Google Scholar 

  28. Cornia PB, Takahashi TA, Lipsky BA (2006) The microbiology of bacteriuria in men: a 5-year study at a Veterans’ Affairs hospital. Diagn Microbiol Infect Dis 56(1):25–30. https://doi.org/10.1016/j.diagmicrobio.2006.03.008

    Article  PubMed  Google Scholar 

  29. Gomila A, Carratalà J, Eliakim-Raz N et al (2019) Clinical outcomes of hospitalised patients with catheter-associated urinary tract infection in countries with a high rate of multidrug-resistance: the COMBACTE-MAGNET RESCUING study. Antimicrob Resist Infect Control 8:198. https://doi.org/10.1186/s13756-019-0656-6

    Article  PubMed  PubMed Central  Google Scholar 

  30. Zielinski MD, Kuntz MM, Polites SF et al (2015) A prospective analysis of urinary tract infections among elderly trauma patients. J Trauma Acute Care Surg 79(4):638–642. https://doi.org/10.1097/TA.0000000000000796

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Funding

This research project receives support from the Innovative Medicines Initiative Joint Undertaking under grant agreement n° 115523 | 115620 | 115737 | 777362 resources of which are composed of financial contribution from the European Union Seventh Framework Programme (FP7/2007-2013) and EFPIA companies in kind contribution. The research leading to these results was conducted as part of the COMBACTE-MAGNET consortium. For further information please refer to www.COMBACTE.com.

Author information

Authors and Affiliations

  1. Department of Medicine E, Beilinson Hospital, Rabin Medical Center, 39 Jabotinsky Road, 49100, Petah-Tikva, Israel

    Adi Turjeman, Tanya Babich, Leonard Leibovici & Noa Eliakim-Raz

  2. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    Adi Turjeman, Tanya Babich, Leonard Leibovici & Noa Eliakim-Raz

  3. Department of Infectious Diseases, Hospital Universitari de Bellvitge, Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), Spanish Network for Research in Infectious Diseases (REIPI RD12/0015)), Instituto de Salud Carlos III (ISCIII), Madrid, Spain

    Miquel Pujol, Jordi Carratalà, Evelyn Shaw & Aina Gomila-Grange

  4. Department of Infectious Diseases, Hospital Universitari Parc Taulí, Barcelona, Spain

    Aina Gomila-Grange

  5. AiCuris Anti-infective Cures GmbH, Wuppertal, Germany

    Cuong Vuong, Ibironke Addy, Irith Wiegand & Christiane Vank

  6. Department of Infection Sciences, Southmead Hospital, North Bristol NHS Trust, Bristol, UK

    Sally Grier & Alasdair MacGowan

  7. Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands

    Nienke Cuperus & Leo van den Heuvel

Authors
  1. Adi Turjeman
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tanya Babich
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Miquel Pujol
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jordi Carratalà
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Evelyn Shaw
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Aina Gomila-Grange
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Cuong Vuong
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Ibironke Addy
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Irith Wiegand
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Sally Grier
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Alasdair MacGowan
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Christiane Vank
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Nienke Cuperus
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Leo van den Heuvel
    View author publications

    You can also search for this author in PubMed Google Scholar

  15. Leonard Leibovici
    View author publications

    You can also search for this author in PubMed Google Scholar

  16. Noa Eliakim-Raz
    View author publications

    You can also search for this author in PubMed Google Scholar

Consortia

COMBACTE MAGNET WP5 RESCUING Study Group and Study Sites

Corresponding author

Correspondence to Adi Turjeman.

Ethics declarations

Ethical approval

The study was approved by the local ethics board of each participating center. Data processing was anonymized and complied with local data protection legislation and with the European Directive on the Privacy of Data (95/46/EC).

Competing interests

The authors declare that they have no competing interests.

Informed consent

Informed consent is not required because of the retrospective design of this study.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Appendix

Appendix

Table 3 List of participating centers
Full size table

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Turjeman, A., Babich, T., Pujol, M. et al. Risk factors for enterococcal urinary tract infections: a multinational, retrospective cohort study. Eur J Clin Microbiol Infect Dis 40, 2005–2010 (2021). https://doi.org/10.1007/s10096-021-04207-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10096-021-04207-4

Keywords

Search

Navigation