Division of Nephrology, Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Republic of Korea.
School of Statistics, College of Natural Science, Seoul National University, Seoul, Republic of Korea.
Sci Rep. 2024 May 13;14(1):10897. doi: 10.1038/s41598-024-61824-7.
Urinary tract infection (UTI) is the most prevalent urological condition worldwide. Choosing appropriate antibiotics for patients who have fever before receiving a culture result is challenging. This retrospective study enrolled patients 394 patients hospitalized at Gangneung Asan Hospital for UTI from May 2017 to April 2021. Fever at 48 h of hospitalization was the analysis point, as this is when the response to antibiotic therapy manifest, although the results of antibiogram are not available. Multivariate analysis was performed to assess the correlation between ESBL producing bacteria (EPB) and fever at 48 h. Overall, 36.3% of patients had EPB and 27.9% had fever at 48 h. In multivariate analysis, a significant positive association was found between EPB and fever (odds ratio 1.17, 95% CI 1.05-1.30, P = 0.004) Female had negative association with multivariate model (OR 0.83, 95% CI 0.73-0.94, P = 0.004). Diabetes did not demonstrate a significant association with EPB. (OR 1.10, 95% CI 0.99-1.22, P = 0.072). Fever at 48 h is associated with EPB and could be considered a predictive factor for EPB infection in patients with UTI. Antibiotic escalation may be considered in patients with fever at 48 h.
尿路感染（UTI）是全球最常见的泌尿科疾病。对于在接受培养结果之前发热的患者，选择合适的抗生素是具有挑战性的。本回顾性研究纳入了 2017 年 5 月至 2021 年 4 月期间在江陵安山医院因 UTI 住院的 394 名患者。以住院后 48 小时的发热为分析点，因为此时抗生素治疗的反应开始显现，尽管药敏试验结果尚未得出。进行多变量分析以评估产超广谱β-内酰胺酶细菌（EPB）与 48 小时发热之间的相关性。总体而言，36.3%的患者存在 EPB，27.9%的患者在 48 小时发热。多变量分析发现，EPB 与发热之间存在显著正相关（优势比 1.17，95%置信区间 1.05-1.30，P=0.004）。女性与多变量模型呈负相关（OR 0.83，95%置信区间 0.73-0.94，P=0.004）。糖尿病与 EPB 无显著相关性（OR 1.10，95%置信区间 0.99-1.22，P=0.072）。48 小时发热与 EPB 相关，可被视为 UTI 患者 EPB 感染的预测因素。对于 48 小时发热的患者，可考虑升级抗生素。
