Introduction and Objectives
Urinary tract infections are the most common type of nosocomial (healthcare facility-acquired) infections, accounting for 40% of all infections in hospitals per year. Such infections add significantly to the economic burden expected from the underlying diseases alone. The aim was:
- –to register the prevalence, the etiology and the antimicrobial susceptibility of nosocomial urinary tract infection (NUTI) pathogens isolated in urology of UHCT;
- –to estimate the recommended standards to urinary catheter use;
- –to improve the expertise of NUTI control.
Material and Methods
The data regarding the prevalence, etiology and antimicrobial resistance of the urinary isolates were collected on two days (26.11.07 and 01.04.09).The second survey was conducted after a two-weeks period of surgical and work pause for the disinfection of hospital clinic's premises. The Vitek 2 automated system was used to identify and to detect antibiotic susceptibility.
The results of two surveys on 26.11.07 and 01.04.09 in Clinic of Urology give prevalence rates 85.71% and 13.04% respectively. There is no distinction between infection and colonization. The isolated micro-organisms on 26.11.07 were, in decreasing order: Escherichia coli (36.66%), Pseudomonas aeruginosa (20%), Candida (16.66%), Enterobacter cloacae (13.33%), Morganella morgani (10%), Acinetobacter baumannii (6.66%), Proteus mirabilis (3.33%), Klebsiella oxytoca (3.33%), Citrobacter freundi (3.33%), Enterococcus faecalis (3.33%). The isolated micro-organisms in 01.04.09 were: Escherichia coli (33.33%), Pseudomonas aeruginosa (33.33%) and Proteus mirabilis (33.33%). One strain of Pseudomonas aeruginosa was isolated from cystoscope. Resistance to ampicillin, one of the most commonly used agents for the empirical treatment of UTIs, was as high as 90% in the case of E. coli. Pseudomonas aeruginosa isolates showed resistance rates of over 70% for quinolone and aminoglycoside antibiotics (except for amikacin), thereby posing a major problem in the management of NUTI in hospital. One of the causes of this problem could be deficient antimicrobial policies.
These data show the high level of antimicrobial resistance amongst the uropathogens causing nosocomial urinary tract infection. The prevalence of yeast is increasing. NUTI is related to the use of indwelling urinary catheters and other intravesical procedures. Discontinuation of catheter usage within 2 days, whenever possible, is the cornerstone to avoiding these infections. NUTI causes huge extra costs for hospitals. The levels and patterns of resistance of pathogens must be a serious cause for concern and a clear reason for stricter guidelines and regulations in antimicrobial policy. The disinfection of clinic's environment significantly contributes at avoiding the NUTIs.
© 2009 European Association of Urology. Published by Elsevier Inc. All rights reserved.