{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T12:17:51Z","timestamp":1788524271187,"version":"build-2803163510"},"reference-count":35,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2022,3,25]],"date-time":"2022-03-25T00:00:00Z","timestamp":1648166400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>The SARS-CoV-2 pandemic might have increased the risks of healthcare-associated infections (HAIs); however, several studies of HAI such as urinary tract infections (UTIs) and catheter-associated urinary tract infections (CAUTIs) have shown contradictory results. The aim of this study is to assess the clinical features of UTIs and bacterial isolates from urine samples of hospitalized COVID-19 patients. We conducted a retrospective observational study including 87 COVID-19 patients with UTIs admitted to our centre. Bacterial UTIs presented were 87: 9 (10.3%) community-acquired UTIs (coinfection group) and 78 (89.6%) hospital-acquired UTIs (superinfection group). In the coinfection group, the most frequent type was non-CAUTI with 5 (55.5%) patients; however, the most frequent UTI in the superinfection group was CAUTI, with 53 (67.9%) patients. The median number of days of hospitalization in coinfected patients was lower than superinfection patients: 13 (IQR 11, 23) vs. 34 days (IQR 23, 47) p &lt; 0.006. All UTI patients admitted to ICU, 38 (43.7%), belonged to the superinfection group. The mortality rate was 26.4% (23\/87), 22\/23 in the superinfection group. The most common microorganisms were E. coli 27 (28.4%), E. faecalis 25 (26.3%) and E. faecium 20 (21.1%). There was an increased incidence of E. faecalis and E. faecium in UTIs as well as hospital-acquired UTIs. This can be related to urethral catheterization during hospitalization, UCI admissions and the number of days of hospitalization.<\/jats:p>","DOI":"10.3390\/jcm11071815","type":"journal-article","created":{"date-parts":[[2022,3,27]],"date-time":"2022-03-27T21:27:51Z","timestamp":1648416471000},"page":"1815","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Urinary Tract Infections in Hospitalized COVID-19 Patients, What\u2019s Up, Doc?"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7241-4208","authenticated-orcid":false,"given":"Beatriz","family":"D\u00edaz Poll\u00e1n","sequence":"first","affiliation":[{"name":"Infectious Disease Unit, Internal Medicine Service, La Paz University Hospital, 28046 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gladys Virginia","family":"Guedez L\u00f3pez","sequence":"additional","affiliation":[{"name":"Clinical Microbiological Service, La Paz University Hospital, 28046 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paloma Mar\u00eda","family":"Garc\u00eda Clemente","sequence":"additional","affiliation":[{"name":"Clinical Microbiological Service, La Paz University Hospital, 28046 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4925-731X","authenticated-orcid":false,"given":"Mar\u00eda","family":"Jim\u00e9nez Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"UCICEC AIDS\/Infectious Diseases, IdiPAZ, La Paz University Hospital, 28046 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3218-4935","authenticated-orcid":false,"given":"Silvia","family":"Garc\u00eda Bujalance","sequence":"additional","affiliation":[{"name":"Clinical Microbiological Service, La Paz University Hospital, 28046 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Rosa","family":"G\u00f3mez-Gil Mir\u00e1","sequence":"additional","affiliation":[{"name":"Clinical Microbiological Service, La Paz University Hospital, 28046 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,3,25]]},"reference":[{"key":"ref_1","unstructured":"WHO (2021, December 08). WHO Coronavirus (COVID-19) Dashboard. WHO Coronavirus (COVID-19) Dashboard With Vaccination Data. Available online: https:\/\/covid19.who.int\/."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1859","DOI":"10.1056\/NEJMc2010419","article-title":"Clinical Characteristics of COVID-19 in China","volume":"382","author":"Goyal","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1061","DOI":"10.1001\/jama.2020.1585","article-title":"Clinical Characteristics of 138 Hospitalized Patients with 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China","volume":"323","author":"Wang","year":"2020","journal-title":"JAMA J. Am. Med. Assoc."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1016\/j.jinf.2020.05.073","article-title":"SARS-CoV-2 infection, clinical features and outcome of COVID-19 in United Kingdom nursing homes","volume":"81","author":"Graham","year":"2020","journal-title":"J. Infect."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1708","DOI":"10.1056\/NEJMoa2002032","article-title":"Clinical characteristics of coronavirus disease 2019 in China","volume":"382","author":"Guan","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"759","DOI":"10.15585\/mmwr.mm6924e2","article-title":"Coronavirus Disease 2019 Case Surveillance\u2014United States, 22 January\u201330 May 2020","volume":"69","author":"Stokes","year":"2020","journal-title":"MMWR. Morb. Mortal. Wkly. Rep."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e533","DOI":"10.1093\/cid\/ciaa1239","article-title":"Empiric Antibacterial Therapy and Community-onset Bacterial Coinfection in Patients Hospitalized With Coronavirus Disease 2019 (COVID-19): A Multi-hospital Cohort Study","volume":"72","author":"Vaughn","year":"2021","journal-title":"Clin. Infect. Dis."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1395","DOI":"10.1016\/j.cmi.2020.06.025","article-title":"Bacterial and fungal coinfection among hospitalized patients with COVID-19: A retrospective cohort study in a UK secondary-care setting","volume":"26","author":"Hughes","year":"2020","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1124","DOI":"10.1017\/ice.2020.156","article-title":"Bacterial and fungal infections in COVID-19 patients: A matter of concern","volume":"41","author":"Zhou","year":"2020","journal-title":"Infect. Control Hosp. Epidemiol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1144","DOI":"10.1111\/myc.13155","article-title":"Isolation of Aspergillus spp. in respiratory samples of patients with COVID-19 in a Spanish Tertiary Care Hospital","volume":"63","author":"Maseda","year":"2020","journal-title":"Mycoses"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e00875-20","DOI":"10.1128\/JCM.00875-20","article-title":"Bacteremia and Blood Culture Utilization during COVID-19 Surge in New York City","volume":"58","author":"Sepulveda","year":"2020","journal-title":"J. Clin. Microbiol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"ofab201","DOI":"10.1093\/ofid\/ofab201","article-title":"Characterization of Bacterial and Fungal Infections in Hospitalized Patients With Coronavirus Disease 2019 and Factors Associated With Health Care-Associated Infections","volume":"8","author":"Kubin","year":"2021","journal-title":"Open Forum Infect. Dis."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1186\/s41479-021-00083-w","article-title":"The role of co-infections and secondary infections in patients with COVID-19","volume":"13","author":"Feldman","year":"2021","journal-title":"Pneumonia"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1016\/j.cmi.2020.07.041","article-title":"Incidence of co-infections and superinfections in hospitalized patients with COVID-19: A retrospective cohort study","volume":"27","author":"Sanjuan","year":"2021","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1007\/s10096-020-04142-w","article-title":"Nosocomial infections associated to COVID-19 in the intensive care unit: Clinical characteristics and outcome","volume":"40","author":"Bardi","year":"2021","journal-title":"Eur. J. Clin. Microbiol. Infect. Dis."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Baker, M.A., Sands, K.E., Huang, S.S., Kleinman, K., Septimus, E.J., Varma, N., Blanchard, J., Poland, R.E., Coady, M.H., and Yokoe, D.S. (2021). The Impact of Coronavirus Disease 2019 (COVID-19) on Healthcare-Associated Infections. Clin. Infect. Dis., ciab688.","DOI":"10.1093\/ofid\/ofab466.171"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1017\/ice.2021.70","article-title":"COVID-19 Pandemic, CLABSI, and CAUTI: The Urgent Need to Refocus on Hardwiring Prevention Efforts","volume":"43","author":"Fakih","year":"2021","journal-title":"Infect. Control Hosp. Epidemiol."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Borobia, A., Carcas, A., Arnalich, F., \u00c1lvarez-Sala, R., Monserrat-Villatoro, J., Quintana, M., Figueira, J., Torres Santos-Olmo, R., Garc\u00eda-Rodr\u00edguez, J., and Mart\u00edn-Vega, A. (2020). A Cohort of Patients with COVID-19 in a Major Teaching Hospital in Europe. J. Clin. Med., 9.","DOI":"10.3390\/jcm9061733"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"115477","DOI":"10.1016\/j.diagmicrobio.2021.115477","article-title":"Bacterial co-infections in COVID-19 pneumonia in a tertiary care hospital: Surfing the first wave","volume":"101","year":"2021","journal-title":"Diagn. Microbiol. Infect. Dis."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1016\/j.ajic.2008.03.002","article-title":"CDC\/NHSN surveillance definition of health care\u2013associated infection and criteria for specific types of infections in the acute care setting","volume":"36","author":"Horan","year":"2008","journal-title":"Am. J. Infect. Control."},{"key":"ref_21","unstructured":"Cercenado Mansilla, E., and Canton, R. (2019). Diagn\u00f3stico microbiol\u00f3gico de las infecciones del tracto urinario. Procedimientos en Microbiolog\u00eda Cl\u00ednica, Sociedad Espa\u00f1ola de Enfermedades Infecciosas y Micro-biolog\u00eda Cl\u00ednica (SEIMC)."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1611","DOI":"10.1093\/cid\/ciz021","article-title":"Clinical practice guideline for the management of asymptomatic bacteriuria: 2019 update by the Infectious Diseases Society of America","volume":"68","author":"Nicolle","year":"2019","journal-title":"Clin. Infect. Dis."},{"key":"ref_23","unstructured":"(2022, March 24). Agencia Espa\u00f1ola de Medicamentos y Productos Sanitarios Tratamientos Disponibles para el Manejo de la Infecci\u00f3n Respiratoria por SARS-CoV-2; 2020. Available online: https:\/\/www.aeped.es\/sites\/default\/files\/15_04_2020_medicamentos_disponibles_para_sars-cov-2_sei.pdf."},{"key":"ref_24","unstructured":"(2021, November 04). EUCAST: Clinical Breakpoints and Dosing of Antibiotics. Available online: https:\/\/www.eucast.org\/clinical_breakpoints\/."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"ofaa578","DOI":"10.1093\/ofid\/ofaa578","article-title":"Prevalence of Co-infection at the Time of Hospital Admission in COVID-19 Patients, A Multicenter Study","volume":"8","author":"Karaba","year":"2020","journal-title":"Open forum Infect. Dis."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Nebreda-Mayoral, T., Miguel-G\u00f3mez, M.A., March-Rossell\u00f3, G.A., Puente-Fuertes, L., Cant\u00f3n-Benito, E., Mart\u00ednez-Garc\u00eda, A.M., Mu\u00f1oz-Mart\u00edn, A.B., and Ordu\u00f1a-Domingo, A. (2021). Bacterial\/fungal infection in hospitalized patients with COVID-19 in a tertiary hospital in the Community of Castilla y Le\u00f3n, Spain. Enferm. Infecc. Microbiol. Clin., in press.","DOI":"10.1016\/j.eimce.2022.02.002"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Musuuza, J.S., Watson, L., Parmasad, V., Putman-Buehler, N., Christensen, L., and Safdar, N. (2021). Prevalence and outcomes of co-infection and superinfection with SARS-CoV-2 and other pathogens: A systematic review and meta-analysis. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0251170"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Devoe, C., Segal, M.R., Wang, L., Stanley, K., Madera, S., Fan, J., Schouest, J., Graham-Ojo, R., Nichols, A., and Prasad, P.A. (2021). Increased rates of secondary bacterial infections, including Enterococcus bacteremia, in patients hospitalized with coronavirus disease 2019 (COVID-19). Infect. Control Hosp. Epidemiol., 1\u20138.","DOI":"10.1017\/ice.2021.391"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1186\/s40560-021-00526-y","article-title":"Community-acquired and hospital-acquired respiratory tract infection and bloodstream infection in patients hospitalized with COVID-19 pneumonia","volume":"9","author":"Baettig","year":"2021","journal-title":"J. Intensive Care"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1016\/j.jinf.2021.07.014","article-title":"Co-infections and superinfections complicating COVID-19 in cancer patients: A multicentre, international study","volume":"83","author":"Gudiol","year":"2021","journal-title":"J. Infect."},{"key":"ref_31","unstructured":"Sociedad Espa\u00f1ola de Medicina Preventiva Salud P\u00fablica e Higiene Prevalencia de infecciones (relacionadas con la asistencia sanitaria y comunitarias) y uso de antimicrobianos en hospitales de agudos. ESTUDIO EPINE-EPPS no 29; 2019."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1038\/s41579-018-0107-z","article-title":"Biofilm-associated infection by enterococci","volume":"17","author":"Chong","year":"2018","journal-title":"Nat. Rev. Microbiol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"414","DOI":"10.3389\/fcimb.2020.00414","article-title":"Proteus mirabilis Biofilm: Development and Therapeutic Strategies","volume":"10","author":"Wasfi","year":"2020","journal-title":"Front. Cell. Infect. Microbiol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"100881","DOI":"10.1016\/j.mgene.2021.100881","article-title":"The prevalence of type 3 fimbriae in Uropathogenic Escherichia coli isolated from clinical urine samples","volume":"28","author":"Khonsari","year":"2021","journal-title":"Meta Gene"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1525","DOI":"10.1016\/j.cmi.2020.07.024","article-title":"Characteristics and predictors of death among 4035 consecutively hospitalized patients with COVID-19 in Spain","volume":"26","author":"Berenguer","year":"2020","journal-title":"Clin. Microbiol. Infect."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/7\/1815\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:43:03Z","timestamp":1760136183000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/7\/1815"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,25]]},"references-count":35,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2022,4]]}},"alternative-id":["jcm11071815"],"URL":"https:\/\/doi.org\/10.3390\/jcm11071815","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,3,25]]}}}