Program Schedule

1031
Comparative Epidemiology of Complicated Urinary Tract Infections (cUTI) by Age among US Hospitals

Session: Poster Abstract Session: UTIs: Epidemiology and Diagnostic Testing
Friday, October 10, 2014
Room: The Pennsylvania Convention Center: IDExpo Hall BC
Background: Data from national nosocomial infection surveillance (NNIS) system indicates that cUTI is a frequent cause of hospitalization across all age groups.  However, few data are available on the comparative epidemiology and outcomes associated with cUTIs due to key Gram-negative pathogens by age among hospitalized patients.  The objectives of this study were to compare the epidemiology and outcomes (hospital LOS and cost) by age among patients with cUTIs due to Gram-negative bacteria across US Hospitals.

Methods: Retrospective observational study using Premier hospital database was conducted.  Inclusion criteria: (1) age ≥ 18 years, (2) patients with an admission to hospital for > 2 days between 7/2012-6/2013, (3) primary diagnosis of cUTI by ICD-9 codes (590.1, 590.80, 590.8, 599.0), (4) ICD-9 codes for E.coli (041.4), K. pneumoniae (041.3) or Pseudomonas (041.7), and (5) received intravenous antibiotic within 3 days of hospital admission.  Demographics, comorbid conditions, Gram-negative pathogens, and outcomes were compared between age categories (18-49 years, 50-64 years, and >= 65 years).

Results: During the study period, 20688 hospitalized patients across 487 hospitals had a primary diagnosis of a cUTI and met the above criteria. Patient characteristics, causative pathogens and outcomes are presented in table below

Patient Characteristics

18-50 years

51-64 years

>=65 years

Female, N (%)

2839(86.7)

2229(72.1)

10774(75.2)

Caucasian, N (%)

1979(60.5)

2105(68.1)

10955(76.5)

Charlson Comorbidity Score, N (%)

 

 

 

0

2091 (63.9)

953 (30.8)

3922 (27.4)

1

629 (19.2)

818(26.4)

3706(25.9)

2

314 (9.6)

518(16.7)

2608(18.2)

>=3

239(7.3)

804(26.0)

4086(28.5)

 G- pathogen, N (%)

 

 

 

E.coli

2834(86.6)

2320(75.0)

10250(71.6)

K. pneumoniae

284(8.7)

500(16.2)

2559 (17.9)

Pseudomonas

111 (3.4)

203(6.6)

1196(8.4)

Polymicrobial

44 (1.3)

70(2.3)

317(2.2)

Patient Outcomes

 

 

 

LOS, mean(Sd)

3.7 (2.8)

4.7 (6.7)

4.8 (3.6)

Total hospital cost, mean(Sd)

$ 5852.7 (7682.3)

$ 7343.1 (8753.7)

$ 7429.5 (6962.3)

Conclusion: Compared to younger patients, older patients (≥50 years) were more likely to have a cUTI due to K. pneumoniae or Pseudomonas. In addition, patients ≥ 51 years, on average, had longer LOS and higher hospitalization cost relative to patients < 50 years.

Michelle Mocarski, MPH1, Qi Zhao, MD, MPH1, Minming Ding, MS1, Shailja Dixit, MD, MS, MPH1 and Thomas Lodise, PharmD2, (1)Forest Research Institute, Jersey City, NJ, (2)Albany College of Pharmacy and Health Sciences, Albany, NY

Disclosures:

M. Mocarski, Forest Research Institute: Employee, Salary

Q. Zhao, Forest Research Institute: Employee, Salary

M. Ding, Forest Research Institute: Employee, Salary

S. Dixit, Forest Research Institute: Employee, Salary

T. Lodise, Forest Research Institute: Consultant, Consulting fee

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