Melzer, M;
Welch, C;
(2017)
Does the presence of a urinary catheter predict severe sepsis in a bacteraemic cohort?
Journal of Hospital Infection
, 95
(4)
pp. 376-382.
10.1016/j.jhin.2017.01.003.
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Abstract
BACKGROUND: Sepsis is a major cause of mortality with an estimated 37,000 deaths in the UK each year. This study aimed to determine host factors that can predict severe sepsis in a bacteraemic cohort. METHODS: From December 2012 to November 2013, demographic, clinical and microbiological data were collected on consecutive patients with bacteraemia at a London teaching hospital. These data were used to categorize patients as having severe or non-severe sepsis. Multi-variate logistic regression was used to determine the association between host factors and severe sepsis. FINDINGS: Five hundred and ninety-four bacteraemic episodes occurred in 500 patients. The majority of cases were in patients aged >50 years (382/594, 64.3%) and in males (346/594, 58.2%). The most common isolates were Escherichia coli (207/594, 34.8%) and meticillin-sensitive Staphylococcus aureus (57/594, 9.6%). In logistic regression multi-variable analysis, site of infection was significantly associated with severe sepsis. For catheter-associated urinary tract infections, the association was significant after adjustment for age, sex, Charlson comorbidity index and where infection was acquired (odds ratio 3.94, 95% confidence interval 1.70-9.11). CONCLUSIONS: Urinary catheters increase the risk of severe sepsis. They should only be used if clinically indicated. If inserted, a care bundle approach should be used and the anticipated removal date should be recorded unless a long-term catheter is required. In the context of sepsis, the presence of a urinary catheter should prompt immediate implementation of 'Sepsis Six' and consideration of transfer to a critical care unit.
| Type: | Article |
|---|---|
| Title: | Does the presence of a urinary catheter predict severe sepsis in a bacteraemic cohort? |
| Location: | England |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1016/j.jhin.2017.01.003 |
| Publisher version: | http://doi.org/10.1016/j.jhin.2017.01.003 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | Bacteraemia, Outcomes, Severe sepsis, Urinary catheter |
| UCL classification: | UCL |
| URI: | https://discovery.ucl.ac.uk/id/eprint/1542945 |
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