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Journal of Clinical Microbiology, December 2008, p. 3980-3986, Vol. 46, No. 12
0095-1137/08/$08.00+0     doi:10.1128/JCM.00339-08
Copyright © 2008, American Society for Microbiology. All Rights Reserved.

Uropathogens and Host Characteristics{triangledown}

James H. Tabibian,1 Jeffrey Gornbein,2 Arash Heidari,1,4 Sarah L. Dien,4 Valerie H. Lau,3 Puneet Chahal,1 Bernard M. Churchill,3 and David A. Haake1,3,4*

Departments of Medicine,1 Biomathematics,2 Urology, David Geffen School of Medicine at the University of California—Los Angeles, Los Angeles, California 90095,3 Veterans Affairs Greater Los Angeles Healthcare Center, Los Angeles, California 900734

Received 18 February 2008/ Returned for modification 6 July 2008/ Accepted 30 September 2008

Uropathogens other than Escherichia coli occur with greater frequency in patients with risk factors for urinary tract infection (UTI). However, little is known about associations between uropathogen species and host characteristics. Three hundred nineteen urine specimens containing a balanced distribution of uropathogen species were selected from inpatients and outpatients at a university hospital clinical microbiology laboratory. Information on host characteristics was retrospectively collected by chart review. Differences in the frequencies of host characteristics in UTI groups, as defined by the causative uropathogen, were compared by chi-square/Fisher analysis. Multivariate classification and regression tree analysis were used to identify host characteristic subsets that distinguish among uropathogen groups. In this exploratory study, several uropathogen species were found to be strongly linked to host characteristics relevant to UTI. Patients with Pseudomonas aeruginosa UTIs were more likely to have undergone urinary tract procedures (43% versus 15% overall), to have a neurogenic bladder (29% versus 12% overall), to have received recent antibiotic therapy (52% versus 24% overall), and to be male (76% versus 28% overall). Patients with Proteus mirabilis UTIs were more likely to have a foreign body in the lower urinary tract (48% versus 30% overall). The classification tree identified males over the age of 27 years who had undergone a prior urinary tract procedure as belonging to a host characteristic profile associated with P. aeruginosa UTI: 38% of patients with P. aeruginosa UTIs fit this profile. These data may be useful for planning future targeted prophylaxis studies.

* Corresponding author. Mailing address: Division of Infectious Diseases, 111F, VA Greater LA Healthcare System, Los Angeles, CA 90073. Phone: (310) 268-2814. Fax: (310) 268-4928. E-mail: dhaake{at}ucla.edu

{triangledown} Published ahead of print on 8 October 2008.

Journal of Clinical Microbiology, December 2008, p. 3980-3986, Vol. 46, No. 12
0095-1137/08/$08.00+0     doi:10.1128/JCM.00339-08
Copyright © 2008, American Society for Microbiology. All Rights Reserved.



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