Evidence map›Paper›PMID 33081714›Full record

ArticleBMC infectious diseases2020

Presence of urinary symptoms in bacteremic urinary tract infection: a retrospective cohort study of Escherichia coli bacteremia.

Anthony D Bai, Michael J Bonares, Samuel Thrall, Chaim M Bell, Andrew M Morris

Open access · goldAbstract read
In one paragraph

Article in BMC infectious diseases, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.9field-weighted citation impact, top 24% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 15 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 5 institutions in 1 country.

Anthony D BaiDivision of Infectious Diseases, McMaster University, 699 Concession St., Hamilton, ON, L8N 4A6, Canada.
Michael J BonaresDivision of Palliative Medicine, University of Toronto, Toronto General Hospital, 200 Elizabeth St., Toronto, ON, M5E 2C4, Canada.
Samuel ThrallDivision of Geriatric Medicine, McMaster University, St. Peter's Hospital Centre for Healthy Aging, 88 Maplewood Ave, Hamilton, ON, L8M 1W9, Canada.
Chaim M BellAntimicrobial Stewardship Program, Sinai Health/University Health Network, Suite 435, 600 University Avenue, Toronto, ON, M5G 1X5, Canada.
Andrew M MorrisAntimicrobial Stewardship Program, Sinai Health/University Health Network, Suite 435, 600 University Avenue, Toronto, ON, M5G 1X5, Canada. andrew.morris@sinaihealth.ca.
McMaster University · CASinai Health System · CASt. Peter's Hospital · CAToronto General Hospital · CAUniversity Health Network · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIt is important to understand clinical features of bacteremic urinary tract infection (bUTI), because bUTI is a serious infection that requires prompt diagnosis and antibiotic therapy. Escherichia coli is the most common and important uropathogen. The objective of our study was to characterize the clinical presentation of E coli bUTI.

methodsRetrospective cohort study of consecutive adult patients admitted for community acquired E. coli bacteremia from January 1, 2015 to December 31, 2016 was conducted at 4 acute care academic and community hospitals in Toronto, Ontario, Canada. Logistic regression models were developed to identify E coli bUTI cases without urinary symptoms.

resultsOf 462 patients with E. coli bacteremia, 284 (61.5%) patients had a urinary source. Of these 284 patients, 161 (56.7%) had urinary symptoms. In a multivariable model, bUTI without urinary symptoms were associated with older age (age < 65 years as reference, age 65-74 years had OR of 2.13 95% CI 0.99-4.59 p = 0.0523; age 75-84 years had OR of 1.80 95% CI 0.91-3.57 p = 0.0914; age > =85 years had OR of 2.95 95% CI 1.44-6.18 p = 0.0036) and delirium (OR of 2.12 95% CI 1.13-4.03 p = 0.0207). Sepsis by SIRS criteria was present in 274 (96.5%) of all bUTI cases and 119 (96.8%) of bUTI cases without urinary symptoms.

conclusionThe majority of patients with E. coli bacteremia had a urinary source. A significant proportion of bUTI cases had no urinary symptoms elicited on history. Elderly and delirious patients were more likely to have bUTI without urinary symptoms. In elderly and delirious patients with sepsis by SIRS criteria but without a clear infectious source, clinicians should suspect, investigate, and treat for bUTI.

Indexed as

AgedAged, 80 and overAnti-Bacterial AgentsBacteremiaCommunity-Acquired InfectionsEscherichia coliEscherichia coli InfectionsFemaleHumansLength of StayLogistic ModelsMaleMiddle AgedOntarioRetrospective StudiesRisk FactorsAnti-Bacterial AgentsBacteremiaDiagnosisEscherichia coliUrinary tract infection

Identifiers

PMID33081714
PMCPMC7576869
OpenAlexW3094617673

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.