000162002 001__ 162002 000162002 005__ 20251017144616.0 000162002 0247_ $$2doi$$a10.1016/j.jhin.2024.05.020 000162002 0248_ $$2sideral$$a144590 000162002 037__ $$aART-2024-144590 000162002 041__ $$aeng 000162002 100__ $$aGómez Zorrilla, S. 000162002 245__ $$aRisk factors and clinical impact of multi drug resistance in healthcare-associated bacteremic urinary tract infections: a post-hoc analysis of a multi center prospective cohort in Spain 000162002 260__ $$c2024 000162002 5060_ $$aAccess copy available to the general public$$fUnrestricted 000162002 5203_ $$aBackground: The global burden associated with antimicrobial resistance is of increasing concern. Aim: To evaluate risk factors associated with multidrug-resistant (MDR) infection and its clinical impact in a cohort of patients with healthcare-associated bacteraemic urinary tract infections (BUTIs). Methods: This was a prospective, multicentre, post-hoc analysis of patients with healthcare-associated-BUTI (ITUBRAS-2). The primary outcome was MDR profile. Secondary outcomes were clinical response (at 48–72 h and at hospital discharge) and length of hospital stay from onset of BUTI. Logistic regression was used to evaluate variables associated with MDR profile and clinical response. Length of hospital stay was evaluated using multivariate median regression. Findings: In all, 443 episodes were included, of which 271 (61.17%) were classified as expressing an MDR profile. In univariate analysis, MDR profile was associated with E. coli episodes (odds ratio (OR): 3.13; 95% confidence interval (CI): 2.11–4.69, P < 0.001) and the extensively drug-resistant (XDR) pattern with P. aeruginosa aetiology (7.84; 2.37–25.95; P = 0.001). MDR was independently associated with prior use of fluoroquinolones (adjusted OR: 2.43; 95% CI: 1.25–4.69), cephalosporins (2.14; 1.35–3.41), and imipenem or meropenem (2.08; 1.03–4.20) but not with prior ertapenem. In terms of outcomes, MDR profile was not associated with lower frequency of clinical cure, but was associated with longer hospital stay. Conclusion: MDR profile was independently associated with prior use of fluoroquinolones, cephalosporins, imipenem, and meropenem, but not with prior ertapenem. MDR-BUTI episodes were not associated with worse clinical cure, although they were independently associated with longer duration of hospital stay. 000162002 536__ $$9info:eu-repo/grantAgreement/ES/ISCIII/CB21-13-00002$$9info:eu-repo/grantAgreement/ES/ISCIII/CB21-13-00084$$9info:eu-repo/grantAgreement/ES/ISCIII/CB21-13-00099$$9info:eu-repo/grantAgreement/ES/ISCIII-REIPI/RD16-0016-0004$$9info:eu-repo/grantAgreement/ES/ISCIII-REIPI/RD16-0016-0005$$9info:eu-repo/grantAgreement/ES/ISCIII-REIPI/RD16-0016-0007$$9info:eu-repo/grantAgreement/ES/ISCIII-REIPI/RD16-0016-0010$$9info:eu-repo/grantAgreement/ES/ISCIII-REIPI/RD16-0016-0011$$9info:eu-repo/grantAgreement/ES/ISCIII-REIPI/RD16-0016-0015 000162002 540__ $$9info:eu-repo/semantics/openAccess$$aby-nd$$uhttps://creativecommons.org/licenses/by-nd/4.0/deed.es 000162002 590__ $$a3.1$$b2024 000162002 592__ $$a1.017$$b2024 000162002 591__ $$aPUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH$$b98 / 419 = 0.234$$c2024$$dQ1$$eT1 000162002 593__ $$aInfectious Diseases$$c2024$$dQ1 000162002 591__ $$aINFECTIOUS DISEASES$$b45 / 137 = 0.328$$c2024$$dQ2$$eT1 000162002 593__ $$aMicrobiology (medical)$$c2024$$dQ1 000162002 593__ $$aMedicine (miscellaneous)$$c2024$$dQ1 000162002 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion 000162002 700__ $$aBecerra Aparicio, F. 000162002 700__ $$aSendra, E. 000162002 700__ $$aZamorano, L. 000162002 700__ $$aGrau, I. 000162002 700__ $$aPintado, V. 000162002 700__ $$aPadilla, B. 000162002 700__ $$aBenito, N. 000162002 700__ $$aBoix Palop, L 000162002 700__ $$aFariñas, M.C. 000162002 700__ $$aPeñaranda, M. 000162002 700__ $$aGamallo, M.R. 000162002 700__ $$aMartínez, J.A. 000162002 700__ $$0(orcid)0000-0001-9262-2461$$aMorte Romea, E.$$uUniversidad de Zaragoza 000162002 700__ $$aDel Pozo, J.L. 000162002 700__ $$aLópez Montesinos, I. 000162002 700__ $$aDurán Jordá, X. 000162002 700__ $$aPonz, R. 000162002 700__ $$aCotarelo, M. 000162002 700__ $$aCantón, R. 000162002 700__ $$aOliver, A. 000162002 700__ $$aRuiz Garbajosa, P. 000162002 700__ $$aHorcajada, J.P. 000162002 7102_ $$11007$$2610$$aUniversidad de Zaragoza$$bDpto. Medicina, Psiqu. y Derm.$$cArea Medicina 000162002 773__ $$g151 (2024), 173-185$$pJ. hosp. infect.$$tJOURNAL OF HOSPITAL INFECTION$$x0195-6701 000162002 8564_ $$s362696$$uhttps://zaguan.unizar.es/record/162002/files/texto_completo.pdf$$yVersión publicada 000162002 8564_ $$s2590225$$uhttps://zaguan.unizar.es/record/162002/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada 000162002 909CO $$ooai:zaguan.unizar.es:162002$$particulos$$pdriver 000162002 951__ $$a2025-10-17-14:19:44 000162002 980__ $$aARTICLE