Comparison of urinary tract-related and catheter-related bloodstream infections in long-term and acute care wards: a retrospective cohort study1
Abstract
BACKGROUND
The characteristics of bloodstream infections in patients admitted to long-term care wards remain unclear. This study examined differences in nosocomial-onset urinary tract-related bloodstream infections (UTRBSIs) and catheter-related bloodstream infections (CRBSIs) between patients admitted to long-term and acute care wards.
METHODS
This retrospective cohort study was conducted at a mixed-care hospital with long-term and acute care wards from April 2015 to March 2024. Patient backgrounds, causative pathogens, antibiotic resistance, and treatment patterns were compared between the two groups.
RESULTS
Among the 252 patients, 108 (42.9%) were diagnosed with UTRBSIs and 87 (34.5%) with CRBSIs. In UTRBSIs, the long-term care group had significantly longer hospitalization (721 vs. 16 days, P < 0.001), more frequent use of indwelling urinary catheters (76.7% vs. 28.6%, P < 0.001), and higher isolation rates of extended-spectrum β-lactamase-producing Enterobacterales (41.1% vs. 8.6%, P < 0.001). Piperacillin/tazobactam and meropenem were significantly more frequently used empirically in the long-term care group. In CRBSIs, the isolation rates of main causative pathogens, including methicillin-resistant Staphylococcus aureus (MRSA) (9.5% vs. 6.7%, P = 0.707) and methicillin-resistant coagulase-negative Staphylococcus spp. (40.5% vs. 48.9%, P = 0.519), showed no significant differences between the two groups despite differences in patient backgrounds. Anti-MRSA agents were…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 252 participants or records.
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