Risk of Invasive Escherichia coli (E. coli) Disease After Elective Urologic Procedures Among Older Adults in the United States.

IF 4.7 3区 医学 Q1 INFECTIOUS DISEASES
Infectious Diseases and Therapy Pub Date : 2025-03-01 Epub Date: 2025-02-07 DOI:10.1007/s40121-024-01096-w
Maureen P Neary, Maryaline Catillon, Nina Ahmad, Marjolaine Gauthier-Loiselle, Jeroen Geurtsen, Alice Qu, Corinne Willame, Martin Cloutier, Antoine C El Khoury, Elie Saade
{"title":"Risk of Invasive Escherichia coli (E. coli) Disease After Elective Urologic Procedures Among Older Adults in the United States.","authors":"Maureen P Neary, Maryaline Catillon, Nina Ahmad, Marjolaine Gauthier-Loiselle, Jeroen Geurtsen, Alice Qu, Corinne Willame, Martin Cloutier, Antoine C El Khoury, Elie Saade","doi":"10.1007/s40121-024-01096-w","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Little is known about the risk of invasive E. coli disease (IED) after elective urologic procedures. We estimated the risk of IED after selected urologic procedures in patients with or without antibiotic prophylaxis, and in controls with no urologic or other surgical procedures.</p><p><strong>Methods: </strong>The Komodo Research Database (01/01/2021-06/30/2023) was used to identify patients ≥ 60 years old with selected urological procedures (index: first urologic procedure date) and randomly selected controls without surgical procedures (index: random date). Patients with urologic procedures were classified into two cohorts based on whether or not they received antibiotic prophylaxis within 14 days prior to and on index date. Entropy balancing adjusted for differences between groups in selected patient characteristics over 6 months pre-index (baseline). IED rates within 30 days post-index were assessed based on recorded diagnosis of E. coli sepsis (ICD-10-CM: A41.51); odds ratios (OR) were estimated using weighted logistic regression. Sensitivity analyses within 90 days and using broader claims-based algorithm for IED were performed.</p><p><strong>Results: </strong>Overall, 141,418 patients had urologic procedures with antibiotic prophylaxis, 200,062 had them without antibiotic prophylaxis, and 424,254 had no procedures. Within 30 days post-index, IED rates were 0.48% and 0.72% among patients with or without antibiotic prophylaxis, respectively, vs. 0.02% among those without any procedures. Among patients with urologic procedures,  > 70% of IED events occurred within 30 days. Patients who had urologic procedures without prophylaxis had a higher risk of developing IED than those with prophylaxis (OR = 1.50, 95% confidence interval [CI: 1.37-1.65]), while patients without any procedures had a lower risk than those with urologic procedures and prophylaxis (OR = 0.04, 95% CI [0.03-0.05]). Similar results were obtained in sensitivity analyses.</p><p><strong>Conclusions: </strong>Urologic procedures were associated with an increased IED risk even with antibiotic prophylaxis. Results suggest an unmet need for additional preventative measures to reduce the burden of IED after urologic procedures.</p>","PeriodicalId":13592,"journal":{"name":"Infectious Diseases and Therapy","volume":" ","pages":"549-567"},"PeriodicalIF":4.7000,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11933614/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Infectious Diseases and Therapy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s40121-024-01096-w","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/2/7 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
引用次数: 0

Abstract

Introduction: Little is known about the risk of invasive E. coli disease (IED) after elective urologic procedures. We estimated the risk of IED after selected urologic procedures in patients with or without antibiotic prophylaxis, and in controls with no urologic or other surgical procedures.

Methods: The Komodo Research Database (01/01/2021-06/30/2023) was used to identify patients ≥ 60 years old with selected urological procedures (index: first urologic procedure date) and randomly selected controls without surgical procedures (index: random date). Patients with urologic procedures were classified into two cohorts based on whether or not they received antibiotic prophylaxis within 14 days prior to and on index date. Entropy balancing adjusted for differences between groups in selected patient characteristics over 6 months pre-index (baseline). IED rates within 30 days post-index were assessed based on recorded diagnosis of E. coli sepsis (ICD-10-CM: A41.51); odds ratios (OR) were estimated using weighted logistic regression. Sensitivity analyses within 90 days and using broader claims-based algorithm for IED were performed.

Results: Overall, 141,418 patients had urologic procedures with antibiotic prophylaxis, 200,062 had them without antibiotic prophylaxis, and 424,254 had no procedures. Within 30 days post-index, IED rates were 0.48% and 0.72% among patients with or without antibiotic prophylaxis, respectively, vs. 0.02% among those without any procedures. Among patients with urologic procedures,  > 70% of IED events occurred within 30 days. Patients who had urologic procedures without prophylaxis had a higher risk of developing IED than those with prophylaxis (OR = 1.50, 95% confidence interval [CI: 1.37-1.65]), while patients without any procedures had a lower risk than those with urologic procedures and prophylaxis (OR = 0.04, 95% CI [0.03-0.05]). Similar results were obtained in sensitivity analyses.

Conclusions: Urologic procedures were associated with an increased IED risk even with antibiotic prophylaxis. Results suggest an unmet need for additional preventative measures to reduce the burden of IED after urologic procedures.

美国老年人择期泌尿外科手术后侵袭性大肠杆菌病的风险
引言:关于选择性泌尿外科手术后侵袭性大肠杆菌病(IED)的风险知之甚少。我们估计了有或没有抗生素预防的患者,以及没有泌尿外科或其他外科手术的对照组在选择泌尿外科手术后发生IED的风险。方法:采用Komodo研究数据库(2021年1月1日- 2023年6月30日),筛选年龄≥60岁的选定泌尿外科手术患者(索引:首次泌尿外科手术日期)和随机选择未手术的对照组(索引:随机日期)。泌尿外科手术患者根据他们是否在指标日期前14天内和当天接受抗生素预防治疗分为两组。熵平衡调整了组间在指数前6个月(基线)选定患者特征的差异。根据记录的大肠杆菌败血症诊断(ICD-10-CM: A41.51)评估指数后30天内的IED发生率;比值比(OR)采用加权逻辑回归估计。在90天内进行敏感性分析,并使用更广泛的基于索赔的IED算法。结果:总体而言,141418例患者在泌尿外科手术中使用了抗生素预防,200,062例患者没有使用抗生素预防,424,254例患者没有使用抗生素预防。指数后30天内,使用或未使用抗生素预防的患者的IED发生率分别为0.48%和0.72%,而未使用任何抗生素预防的患者为0.02%。在接受泌尿外科手术的患者中,70%的IED事件发生在30天内。未进行预防的泌尿外科手术患者发生IED的风险高于接受预防的患者(OR = 1.50, 95%可信区间[CI: 1.37-1.65]),而未进行任何手术的患者发生IED的风险低于接受泌尿外科手术和预防的患者(OR = 0.04, 95% CI[0.03-0.05])。在敏感性分析中也得到了类似的结果。结论:泌尿外科手术与IED风险增加相关,即使使用抗生素预防。结果表明,需要额外的预防措施来减少泌尿外科手术后IED的负担。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Infectious Diseases and Therapy
Infectious Diseases and Therapy Medicine-Microbiology (medical)
CiteScore
8.60
自引率
1.90%
发文量
136
审稿时长
6 weeks
期刊介绍: Infectious Diseases and Therapy is an international, open access, peer-reviewed, rapid publication journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of infectious disease therapies and interventions, including vaccines and devices. Studies relating to diagnostic products and diagnosis, pharmacoeconomics, public health, epidemiology, quality of life, and patient care, management, and education are also encouraged. Areas of focus include, but are not limited to, bacterial and fungal infections, viral infections (including HIV/AIDS and hepatitis), parasitological diseases, tuberculosis and other mycobacterial diseases, vaccinations and other interventions, and drug-resistance, chronic infections, epidemiology and tropical, emergent, pediatric, dermal and sexually-transmitted diseases.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信