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
AU - Patel, Payal K.
AU - Rogers, Mary A.M.
N1 - Funding Information:
We thank Debbie Zawol, MSN, RN, ACNS-BC, Karen Schumacher, RN, and Derek Dimcheff, MD, PhD for their roles in reviewing medical records of cases to rule out cases that displayed evidence of primary bloodstream infections with hematogenous spread to the kidney. Funding/support: This project was supported by a Veterans Affairs Clinical Sciences Research & Development Merit Review Award (EPID-011-11S). The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the US government.
PY - 2019/4
Y1 - 2019/4
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 48hours or longer after admission and a blood culture obtained within 14days 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 48hours or longer after admission and a blood culture obtained within 14days 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 - Healthcare–associated infectionBlood transfusion
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U2 - 10.1016/j.ajic.2018.09.013
DO - 10.1016/j.ajic.2018.09.013
M3 - Article
C2 - 30470527
AN - SCOPUS:85056752531
VL - 47
SP - 381
EP - 386
JO - American Journal of Infection Control
JF - American Journal of Infection Control
SN - 0196-6553
IS - 4
ER -