Jen Cihlar, DO, Vanderbilt University Medical Center
This retrospective cohort study looked at risk factors bloodstream infections due to UTI (bUTI) in cancer patients, recurrence, and MDR organisms in 561 episodes between 2008 to 2019. Salient risk factors for bUTI identified were primary neoplasm of urinary tract (62%), associated urinary tract instrumentation such as presence of catheter, stents, nephrostomies or neobladders (59%), recent urinary tract manipulation (50%), and prior admission for non-bacteremic UTI (63%). MDR gram-negative bacteria were implicated in 19.6% of episodes, similar to rates in other studies. Recurrent bUTI occurred in 14% of patients and based on multivariable analysis, the authors created a predictive score by assigning points to certain risk factors based on regression coefficients to identify patients at increased risk of recurrence (discriminatory power of 0.857, 95% CI 0.814–0.899). The authors recognize the utility of this tool ultimately requires external validation. Though given the effect recurrent bUTI could have on oncologic therapy and overall patient outcomes, this tool could be useful in certain clinical settings, such as prophylaxis strategies for identified high-risk patients undergoing urologic procedures, decisions on urologic instrument removal, or even be used for antibiotic and diagnostic stewardship efforts for low-risk patients to help guide antibiotic use and infectious work up.
Reference:
Grafia I, Moll-Febrer A, Santillán SJ, et al. Multidrug resistance and recurrence in urinary bacteraemia among cancer patients. J Antimicrob Chemother. 2025;80(11):3026-3033. doi:10.1093/jac/dkaf335