Role of transfusions in the development of hospital-acquired urinary tract–related bloodstream infection among United States Veterans

M. Todd Greene, Sanjay Saint, David Ratz, Latoya Kuhn, Jennifer I.M. Davis, Payal K. Patel, Mary A.M. Rogers

Research output: Contribution to journalArticle

Abstract

Background: Urinary tract–related bloodstream infection (BSI) is associated with substantial morbidity, mortality, and financial costs. We examined the role of red blood cell (RBC) transfusions on developing this condition among US Veterans. Methods: We conducted a matched case-control study among adult inpatients admitted to 4 Veterans Affairs hospitals. Cases were patients with a positive urine culture result obtained 48 hours or longer after admission and a blood culture obtained within 14 days of the urine culture, which grew the same organism. Controls included patients with a positive urine culture result who were at risk for but did not develop BSI (control group 1) and patients without a positive urine culture result who were present in the facility at the time of case diagnosis (control group 2). Results: Compared with the findings in control group 1, receipt of RBCs was not significantly associated with urinary tract–related BSI (odds ratio, 1.03; 95% confidence interval, 1.00-1.07; P = .07). However, we found increased odds of urinary tract–related BSI compared with the results in patients without infection (control group 2) (odds ratio, 1.11; 95% confidence interval, 1.06-1.17; P < .001). Conclusions: Given the heightened risk of urinary tract–related BSI associated with receiving a greater number of RBC transfusions, adhering to recommendations to transfuse the minimum amount of blood products necessary may minimize the risk of this infection among Veterans.

Original languageEnglish (US)
JournalAmerican Journal of Infection Control
DOIs
StateAccepted/In press - Jan 1 2018
Externally publishedYes

Fingerprint

Veterans
Urine
Infection
Erythrocyte Transfusion
Control Groups
Infection Control
Odds Ratio
Confidence Intervals
Veterans Hospitals
Case-Control Studies
Inpatients
Morbidity
Costs and Cost Analysis
Mortality

Keywords

  • Health care–associated infectionBlood transfusion

ASJC Scopus subject areas

  • Epidemiology
  • Health Policy
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

Cite this

Role of transfusions in the development of hospital-acquired urinary tract–related bloodstream infection among United States Veterans. / Greene, M. Todd; Saint, Sanjay; Ratz, David; Kuhn, Latoya; Davis, Jennifer I.M.; Patel, Payal K.; Rogers, Mary A.M.

In: American Journal of Infection Control, 01.01.2018.

Research output: Contribution to journalArticle

@article{68ffcf2ec1174dea80ced7c8d1f4442b,
title = "Role of transfusions in the development of hospital-acquired urinary tract–related bloodstream infection among United States Veterans",
abstract = "Background: Urinary tract–related bloodstream infection (BSI) is associated with substantial morbidity, mortality, and financial costs. We examined the role of red blood cell (RBC) transfusions on developing this condition among US Veterans. Methods: We conducted a matched case-control study among adult inpatients admitted to 4 Veterans Affairs hospitals. Cases were patients with a positive urine culture result obtained 48 hours or longer after admission and a blood culture obtained within 14 days of the urine culture, which grew the same organism. Controls included patients with a positive urine culture result who were at risk for but did not develop BSI (control group 1) and patients without a positive urine culture result who were present in the facility at the time of case diagnosis (control group 2). Results: Compared with the findings in control group 1, receipt of RBCs was not significantly associated with urinary tract–related BSI (odds ratio, 1.03; 95{\%} confidence interval, 1.00-1.07; P = .07). However, we found increased odds of urinary tract–related BSI compared with the results in patients without infection (control group 2) (odds ratio, 1.11; 95{\%} confidence interval, 1.06-1.17; P < .001). Conclusions: Given the heightened risk of urinary tract–related BSI associated with receiving a greater number of RBC transfusions, adhering to recommendations to transfuse the minimum amount of blood products necessary may minimize the risk of this infection among Veterans.",
keywords = "Health care–associated infectionBlood transfusion",
author = "Greene, {M. Todd} and Sanjay Saint and David Ratz and Latoya Kuhn and Davis, {Jennifer I.M.} and Patel, {Payal K.} and Rogers, {Mary A.M.}",
year = "2018",
month = "1",
day = "1",
doi = "10.1016/j.ajic.2018.09.013",
language = "English (US)",
journal = "American Journal of Infection Control",
issn = "0196-6553",
publisher = "Mosby Inc.",

}

TY - JOUR

T1 - Role of transfusions in the development of hospital-acquired urinary tract–related bloodstream infection among United States Veterans

AU - Greene, M. Todd

AU - Saint, Sanjay

AU - Ratz, David

AU - Kuhn, Latoya

AU - Davis, Jennifer I.M.

AU - Patel, Payal K.

AU - Rogers, Mary A.M.

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background: Urinary tract–related bloodstream infection (BSI) is associated with substantial morbidity, mortality, and financial costs. We examined the role of red blood cell (RBC) transfusions on developing this condition among US Veterans. Methods: We conducted a matched case-control study among adult inpatients admitted to 4 Veterans Affairs hospitals. Cases were patients with a positive urine culture result obtained 48 hours or longer after admission and a blood culture obtained within 14 days of the urine culture, which grew the same organism. Controls included patients with a positive urine culture result who were at risk for but did not develop BSI (control group 1) and patients without a positive urine culture result who were present in the facility at the time of case diagnosis (control group 2). Results: Compared with the findings in control group 1, receipt of RBCs was not significantly associated with urinary tract–related BSI (odds ratio, 1.03; 95% confidence interval, 1.00-1.07; P = .07). However, we found increased odds of urinary tract–related BSI compared with the results in patients without infection (control group 2) (odds ratio, 1.11; 95% confidence interval, 1.06-1.17; P < .001). Conclusions: Given the heightened risk of urinary tract–related BSI associated with receiving a greater number of RBC transfusions, adhering to recommendations to transfuse the minimum amount of blood products necessary may minimize the risk of this infection among Veterans.

AB - Background: Urinary tract–related bloodstream infection (BSI) is associated with substantial morbidity, mortality, and financial costs. We examined the role of red blood cell (RBC) transfusions on developing this condition among US Veterans. Methods: We conducted a matched case-control study among adult inpatients admitted to 4 Veterans Affairs hospitals. Cases were patients with a positive urine culture result obtained 48 hours or longer after admission and a blood culture obtained within 14 days of the urine culture, which grew the same organism. Controls included patients with a positive urine culture result who were at risk for but did not develop BSI (control group 1) and patients without a positive urine culture result who were present in the facility at the time of case diagnosis (control group 2). Results: Compared with the findings in control group 1, receipt of RBCs was not significantly associated with urinary tract–related BSI (odds ratio, 1.03; 95% confidence interval, 1.00-1.07; P = .07). However, we found increased odds of urinary tract–related BSI compared with the results in patients without infection (control group 2) (odds ratio, 1.11; 95% confidence interval, 1.06-1.17; P < .001). Conclusions: Given the heightened risk of urinary tract–related BSI associated with receiving a greater number of RBC transfusions, adhering to recommendations to transfuse the minimum amount of blood products necessary may minimize the risk of this infection among Veterans.

KW - Health care–associated infectionBlood transfusion

UR - http://www.scopus.com/inward/record.url?scp=85056752531&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85056752531&partnerID=8YFLogxK

U2 - 10.1016/j.ajic.2018.09.013

DO - 10.1016/j.ajic.2018.09.013

M3 - Article

JO - American Journal of Infection Control

JF - American Journal of Infection Control

SN - 0196-6553

ER -