Faculty of Medicine, University of Nis, Bulevar Dr. Z. Djindjica 81, 18000, Niš, Serbia.
Clinic for Nephrology, Clinical Center Nis, Bulevar Dr. Z. Djindjica 48, 18000, Niš, Serbia.
Sci Rep. 2021 Jul 13;11(1):14414. doi: 10.1038/s41598-021-93912-3.
Occurrence of urosepsis is not uncommon following urinary tract infections (UTI). However, there is a lack of evidence explaining the risk factors predisposing to urosepsis in patients with chronic kidney disease (CKD). This retrospective study was undertaken to evaluate the incidence and possible risk factors for urosepsis among patients hospitalized with UTI in a cohort of CKD patients. Patients were divided into the urosepsis group and the non-urosepsis group. Of 489 hospitalized patients with UTI, 70 (14.3%) acquired urosepsis. Stepwise multivariate logistic regression demonstrated that diabetes, urinary catheter and length of hospital stay (p < 0.001 for all) were significant independent predictive risk factors for urosepsis in CKD patients with UTI in addition to age, glomerular filtration rate, hydronephrosis, acute kidney injury and E. coli infection (p < 0.05 for all). Finally, Klebsiella spp. cases were associated with significantly higher odds for urosepsis than E. coli cases (OR: 3.5, 95% CI: 2.86-7.23, p < 0.001 vs. OR: 1.38, 95% CI: 1.19-3.69, p = 0.038). Diabetes, presence of an indwelling urinary catheter, length of hospitalization, and infection with Klebsiella spp were independent risk factors for urosepsis in CKD patients with UTI.
尿路感染（UTI）后发生尿脓毒症并不罕见。然而，目前缺乏解释导致慢性肾脏病（CKD）患者发生尿脓毒症的风险因素的证据。本回顾性研究旨在评估 CKD 患者尿路感染住院患者中尿脓毒症的发生率和可能的风险因素。患者分为尿脓毒症组和非尿脓毒症组。在 489 例因 UTI 住院的患者中，有 70 例（14.3%）发生了尿脓毒症。逐步多元逻辑回归表明，糖尿病、导尿管和住院时间（p < 0.001）是 CKD 患者尿路感染并发尿脓毒症的独立预测风险因素，除年龄、肾小球滤过率、肾积水、急性肾损伤和大肠埃希菌感染外（p < 0.05）。最后，与大肠埃希菌感染相比，克雷伯菌属感染与尿脓毒症的发生显著相关（OR：3.5，95%CI：2.86-7.23，p < 0.001 与 OR：1.38，95%CI：1.19-3.69，p = 0.038）。糖尿病、留置导尿管、住院时间和克雷伯菌属感染是 CKD 患者尿路感染并发尿脓毒症的独立危险因素。
