Role of transfusions in the development of hospital-acquired urinary tract–related bloodstream infection among United States Veterans

Abstract: Background: Urinary tract-related bloodstream infection (BSI) is associated with substantial morbidity, mortality and financial costs. We examined the role of red blood cell transfusions on developing this condition among United States 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 obtained 48 hours or more after admission and a blood culture obtained within 14 days of the urine culture, which grew the same organism. Controls included patients with a positive urine culture who were at risk for BSI but did not develop one (control group 1) and patients without a positive urine culture who were present in the facility at the time of case diagnosis (control group 2). Results: Compared to control group 1, receipt of red blood cells was not significantly associated with urinary tract-related BSI (OR = 1.03, 95% CI 1.00 – 1.07, p=0.07). However, we detected increased odds of urinary tract-related BSI when compared to patients without infection (control group 2) (OR = 1.11, 95% CI 1.06 – 1.17, p<0.001). Conclusions: Given the heightened risk of urinary tract-related BSI associated with receiving a greater number of red blood cell transfusions, adhering to recommendations to transfuse the minimum amount of blood products necessary may minimize the risk of this infection among Veterans.