Short summary

Urosepsis is defined as a blood stream infection caused by an infection in the urogenital tract. In a retrospective cohort study based on registry data from patients admitted to a single Danish hospital centre, the risk factors for and the mortality of urosepsis cases with E. coli are examined. The outcome of urosepsis is furthermore assessed in relation to the antibiotic treatment of the patient and the antibiotic resistance of the infection-causing bacteria.

Rationale

Urosepsis is a life-threatening infection with high morbidity and mortality, where the triggering infection in the urogenital tract is not always detected. Effective antibiotic treatment of urosepsis also require treatment of the underlying focal infection. What is the validity of diagnosis codes in LPR for patients suspected of urosepsis. What is the trend in mortality rates in a Danish cohort of urosepsis patients with documented blood stream infection during the study period? Which risk factors are associated with mortality? Do patients with urosepsis receive appropriate empirical antimicrobial therapy? Do clinicians tailor their final antibiotic therapy to the resistance patterns of the pathogens reported to the clinical department in charge of the patients?

Description of the cohort

Adults admitted to a Danish hospital with urinary tract infection and bacteraemia between 2007 and 2023.

Data and biological material

Data from the electronic laboratory system in clinical microbiology (MADS) and clinical biochemistry (LABKA and BCC), the medication module of the hospital electronic patient records, the National Patient Registry (LPR_ADM), Cause of Death Registry (DAR), The Danish National Prescription Registry (LMDB), and the socioeconomic registries UDDF, IND, and FAIK.

Publications associated with the project

Sim PJW, Li Z, Aung AH, Coia JE, Chen M, Nielsen SL, Jensen TG, Møller JK, Dessau RB, Póvoa P, Gradel KO, Chow A; SG-DK Bacteraemia study group. Comparative epidemiology of bacteraemia in two ageing populations: Singapore and Denmark. Epidemiol Infect. 2024 Apr 29;152:e74. doi: 10.1017/S0950268824000645.

Garvik OS, Póvoa P, Vinholt PJ, Nielsen SL, Jensen TG, Frederiksen H, Chen M, Dessau RB, Coia JE, Møller JK, Gradel KO. Detection of infections by computerized capture of peaks in longitudinally measured C-reactive protein levels. Biomark Med. 2023 Aug;17(15):635-642. doi: 10.2217/bmm-2023-0419.

Møller JK, Sørensen M, Hardahl C. Prediction of risk of acquiring urinary tract infection during hospital stay based on machine-learning: A retrospective cohort study. PLoS One. 2021 Mar 31;16(3):e0248636. doi:10.1371/journal.pone.0248636.

Andreassen S, Møller JK, Eliakim-Raz N, Lisby G, Ward L. A comparison of predictors for mortality and bacteraemia in patients suspected of infection. BMC Infect Dis. 2021 Aug 23;21(1):864. doi: 10.1186/s12879-021-06547-0.