Background Although catheter-associated urinary tract infection (CA-UTI) is a major healthcare-related problem worldwide, there is a scarcity of current data from countries with high antimicrobial resistance rates. We aimed to determine the clinical outcomes of patients with CA-UTI compared to those of patients with other sources of complicated urinary tract infection (cUTI), and to assess the impact of antimicrobial resistance. We also aimed to identify the factors influencing 30-day mortality among patients with CA-UTI. Methods This was a multicentre, multinational retrospective cohort study including hospitalised adults with cUTI between January 2013 and December 2014 in twenty hospitals from eight countries from southern Europe, Turkey and Israel. The primary endpoint was 30-day mortality. The secondary endpoints were length of hospital stay, symptom improvement after 7 days' treatment, symptom recurrence at 30 days and readmission 60 days after hospital discharge. Results Of the 807 cUTI episodes, 341 (42.2%) were CA-UTIs. The time from catheter insertion to cUTI diagnosis was less than 2 weeks in 44.6% of cases. Overall, 74.5% of cases had hospital or healthcare-acquired CA-UTI. Compared to patients with other cUTI aetiologies, those with CA-UTI had the following characteristics: they were more frequently males, older, admitted for a reason other than cUTI and admitted from a long-term care facility; had higher Charlson's comorbidity index; and more frequently had polymicrobial infections and multidrug-resistant Gram-negative bacteria (MDR-GNB). Patients with CA-UTI also had significantly higher 30-day mortality rates (15.2% vs 6%) and longer hospital stay (median 14 [interquartile range -IQR- 7-27] days vs 8 [IQR 5-14] days) than patients with cUTI of other sources. After adjusting for confounders, CA-UTI was not independently associated with an increased risk of mortality (odds ratio, 1.40; 95% confidence interval, 0.77-2.54), and neither was the presence of MDR-GNB. Conclusions CA-UTI was the most frequent source of cUTI, affecting mainly frail patients. The mortality of patients with CA-UTI was high, though this was not directly related to the infection.

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在多药耐药率较高的国家中，住院的导管相关性尿路感染患者的临床结局：COMBACTE-MAGNET RESCUING研究。

背景技术尽管与导管相关的尿路感染（CA-UTI）是全球范围内与医疗保健相关的主要问题，但目前缺乏来自耐药率高的国家的最新数据。我们旨在确定CA-UTI患者与其他复杂性尿路感染（cUTI）患者相比的临床结局，并评估抗菌素耐药性的影响。我们还旨在确定影响CA-UTI患者30天死亡率的因素。方法这是一项多中心，多国回顾性队列研究，包括2013年1月至2014年12月在来自欧洲南部，土耳其和以色列的八个国家的20家医院中住院的cUTI成年人。主要终点是30天死亡率。次要终点是住院时间，治疗7天后症状改善，出院后30天症状复发，出院60天后再次入院。结果807例cUTI发作中，有341例（42.2％）是CA-UTI。从导管插入到cUTI诊断的时间少于2周，占44.6％的病例。总体而言，有74.5％的病例患有医院或医疗机构获得的CA-UTI。与具有其他cUTI病因的患者相比，患有CA-UTI的患者具有以下特征：他们是男性，年龄较大，由于非cUTI的原因而入院并从长期护理机构就诊；具有较高的查尔森合并症指数；且更常见的是多微生物感染和多药耐药革兰氏阴性菌（MDR-GNB）。CA-UTI患者的30天死亡率也显着较高（15。与其他来源的cUTI患者相比，住院时间更长（分别为2％和6％）和更长的住院时间（中位14 [四分位间距-IQR-7-27]天vs 8 [IQR 5-14]天）。调整混杂因素后，CA-UTI并没有独立地导致死亡风险增加（赔率，1.40； 95％置信区间，0.77-2.54），MDR-GNB均不存在。结论CA-UTI是最常见的cUTI来源，主要影响体弱的患者。CA-UTI患者的死亡率很高，尽管这与感染没有直接关系。结论CA-UTI是最常见的cUTI来源，主要影响体弱的患者。CA-UTI患者的死亡率很高，尽管这与感染没有直接关系。结论CA-UTI是最常见的cUTI来源，主要影响体弱的患者。CA-UTI患者的死亡率很高，尽管这与感染没有直接关系。