Factors associated with specific uropathogens in catheter-associated urinary tract infection: developing a clinical prediction model.
OBJECTIVES
To identify characteristics associated with particular groups of uropathogens in catheter-associated urinary tract infection (CA-UTI) and to develop clinical prediction rules for identifying these groups.


METHODS
Demographic, clinical and microbiological data were analysed from patients with CA-UTI. Infections were categorized into enteric Gram-negative rods, nonfermenters, Gram-positive cocci and fungal. Variables were analysed using univariate and multiple logistic regression analyses, and were used to develop clinical prediction rules.


RESULTS
A total of 492 patients were included in the study. Candida species were the most common uropathogens (30.7%), followed by enterococci (17.3%), Escherichia coli (12.0%), Pseudomonas spp. (10.8%), Klebsiella spp. (7.9%) and staphylococci (6.5%). Clinical prediction rules for the bacterial uropathogenic groups showed poor-to-fair discriminatory power, with sensitivities of <40% and specificities of >90%. However, clinical prediction rules showed good discriminatory power for fungal infections, with a sensitivity of 67.3% and a specificity of 78.1%.


CONCLUSIONS
Clinical prediction rules developed for identifying specific groups of bacterial uropathogens in patients with CA-UTI had a low sensitivity, whereas those for fungal infections showed good discriminatory power. Further studies to develop more refined and sensitive tools for predicting specific bacterial uropathogens in CA-UTI are warranted.
['Oh|Won Sup|WS|', 'Hur|Ji-An|JA|', 'Kim|Eu Suk|ES|', 'Park|Kyung-Hwa|KH|', 'Choi|Hee Kyoung|HK|', 'Moon|Chisook|C|', 'Kim|Baek-Nam|BN|']
D000368:Aged D000900:Anti-Bacterial Agents D000935:Antifungal Agents D055499:Catheter-Related Infections D015331:Cohort Studies D003428:Cross Infection D005260:Female D005544:Forecasting D006090:Gram-Negative Bacteria D016905:Gram-Negative Bacterial Infections D016908:Gram-Positive Bacterial Infections D006095:Gram-Positive Cocci D006801:Humans D008297:Male D008826:Microbial Sensitivity Tests D008875:Middle Aged D009181:Mycoses D014546:Urinary Catheterization D014552:Urinary Tract Infections
Catheter-associated urinary tract infection prediction model sensitivity aetiology risk factor urinary catheterization