Benea Adela, Turaiche Mirela, Rosca Ovidiu, Hogea Elena, Suba Madalina-Ianca, Varga Norberth-Istvan, Shetty Uday Shree Akkala, Porav-Hodade Daniel, Enatescu Ileana, Ilie Adrian Cosmin, Rachieru Ciprian, Lighezan Daniel-Florin, Sarau Oana Silvana, Sarau Cristian Andrei
Doctoral School, Faculty of Medicine, "Victor Babes" University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania.
Methodological and Infectious Diseases Research Center, Faculty of Medicine, "Victor Babes" University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania.
Microorganisms. 2025 May 14;13(5):1130. doi: 10.3390/microorganisms13051130.
Urinary tract infections (UTIs) remain a leading cause of healthcare-associated morbidity, particularly in patients with indwelling urinary catheters. This study aimed to compare catheter-associated (CAUTIs) and non-catheter-associated UTIs of the lower tract among hospitalized adults in Western Romania, identify potential predictors of prolonged hospital stay, and explore the interplay of inflammatory markers and clinical outcomes. We retrospectively examined 130 patients diagnosed with UTIs from 2020 to 2024. Demographic data, comorbidities, laboratory parameters (CRP, procalcitonin, fibrinogen, white blood cell counts), and microbiology results were assessed. Patients were divided into CAUTI (n = 72) and non-catheter UTI (n = 58) groups. CAUTI patients had a significantly longer mean hospital stay (13.9 ± 4.3 vs. 11.7 ± 3.8 days, = 0.01). (29.2%), (18.5%), and mixed flora (11.5%) predominated overall, with trending higher in CAUTIs (15.3% vs. 5.2%). Diabetic status correlated with higher CRP (54.7 ± 18.2 vs. 46.9 ± 15.7 mg/dL, = 0.04) and increased intensive care unit (ICU) admission (23.5% vs. 9.4%, = 0.03). In a subgroup of 65 patients, CRP demonstrated a moderate positive correlation with length of stay (r = 0.47, = 0.02). Logistic regression indicated that CAUTI was associated with 2.3-fold higher odds of extended hospitalization (95% CI: 1.2-4.4, = 0.02), adjusting for age, diabetes, and CRP levels. CAUTIs are linked to more resistant pathogens, longer hospitalizations, and potentially greater clinical complications. Diabetes further compounds risk, as reflected in higher inflammatory markers and ICU admissions.
尿路感染（UTIs）仍然是医疗相关发病的主要原因，尤其是在留置导尿管的患者中。本研究旨在比较罗马尼亚西部住院成人下尿路导管相关尿路感染（CAUTIs）和非导管相关尿路感染，确定住院时间延长的潜在预测因素，并探讨炎症标志物与临床结果之间的相互作用。我们回顾性研究了2020年至2024年期间诊断为UTIs的130例患者。评估了人口统计学数据、合并症、实验室参数（CRP、降钙素原、纤维蛋白原、白细胞计数）和微生物学结果。患者分为CAUTI组（n = 72）和非导管性UTI组（n = 58）。CAUTI患者的平均住院时间明显更长（13.9±4.3天 vs. 11.7±3.8天，P = 0.01）。大肠埃希菌（29.2%）、肺炎克雷伯菌（18.5%）和混合菌群（11.5%）总体上占主导地位，大肠埃希菌在CAUTIs中比例更高（15.3% vs. 5.2%）。糖尿病状态与较高的CRP水平相关（54.7±18.2 vs. 46.9±15.7 mg/dL，P = 0.04），且重症监护病房（ICU）入院率增加（23.5% vs. 9.4%，P = 0.03）。在65例患者的亚组中，CRP与住院时间呈中度正相关（r = 0.47，P = 0.02）。逻辑回归表明，调整年龄、糖尿病和CRP水平后，CAUTI与延长住院时间的几率高2.3倍相关（95% CI：1.2 - 4.4，P = 0.02）。CAUTIs与更具耐药性的病原体、更长的住院时间以及潜在的更多临床并发症相关。糖尿病进一步增加了风险，这在更高的炎症标志物和ICU入院率中得到体现。
