1678. Evaluation of Sodium-Glucose Co-Transporter 2 Inhibitor Therapy and Other Potential Risk Factors for the Development of Bacteremia in Patients with Urosepsis

BACKGROUND: Though sodium-glucose co-transporter 2 (SGLT2) inhibitors have been associated with an increased risk of urinary tract infection, it is unknown whether SGLT2 inhibitors increase the risk of urinary-source bacteremia. Early recognition of bacteremia risk factors in patients with urosepsis could allow rapid management to improve patient outcomes. The purpose of this study is to assess patients presenting with urosepsis and a positive urine culture to evaluate the impact of sodium-glucose co-transporter 2 (SGLT2) inhibitor receipt and other potential risk factors for developing bacteremia. METHODS: This was a single-center, retrospective, case-control study performed at a community hospital. Patients were included if they presented with a positive urine culture and met pre-specified criteria for urosepsis. Patients were categorized in one of two groups: bacteremia and non-bacteremia. The following patients were excluded: confirmed pregnancy, age less than 18 years, and/or a proven source of bacteremia outside the urogenital tract. The primary endpoint assessed the percentage of patients taking a SGLT2 inhibitor in the bacteremia versus non-bacteremia groups. Independent risk factors for bacteremia were assessed via binary logistic regression. Additional statistical analysis included chi-square for categorical data and Student’s t-test for continuous data. RESULTS: A total of 162 patients were analyzed in the study (n=81 in bacteremia and non-bacteremia groups). There was no difference in percentage of patients with or without bacteremia who received SGLT2 inhibitor therapy (p = 0.499). The following were identified as independent risk factors for bacteremia in the binary logistic regression analysis: temperature ≥ 100.4 degrees Fahrenheit (OR 4.1; 95% CI 1.5 – 11.4), bicarbonate level < 20 mmol/L (OR 11.4; 95% CI 3.1 – 41.5), and blood glucose level > 180 mg/dL (OR 3.9; 95% CI 1.3 – 11.6). CONCLUSION: In this study of patients in a community hospital, SGLT2 inhibitors in the setting of patients with urosepsis and positive urine cultures did not increase the risk for bacteremia. Independent risk factors associated with an increased risk of bacteremia included temperature ≥ 100.4 degrees Fahrenheit, bicarbonate level < 20 mmol/L, and blood glucose level > 180 mg/dL. DISCLOSURES: All Authors: No reported disclosures