Catheter-associated urinary tract infections in Clinical Center of Banja Luka

Abstract

Catheter-associated urinary tract infections are the most common nosocomial infections of the urinary tract, and among the most common nosocomial infections in general. The major problems of these infections include antibiotic resistance and enormous direct and indirect cost of treatment. A retrospective study on major causes of infections and antibiotic resistance was conducted at four clinics of the Clinical Center of Banja Luka. An anonymous questionnaire was distributed to nursing staff dealing with urinary catheters in order to get an overview of their clinical performance. The results showed that in 89% of cases (out of 198 patients with developed catheter-associated urinary tract infection) infections were caused by gram-negative bacteria, in 7% by gram-positive bacteria and in 4% by candida. The most common bacteria were: Escherichia coli (33.6%), Pseudomonas aeruginosa (14.1%), Proteus mirabilis (13.3%), and Enterobacter (10.5%). Majority of bacteria presented with extremely high resistance (72-100%) to ampicillin, gentamycin and cotrimoxazole, and in some cases a significant resistance to ciproflaxacine, nalidixic acid, ceftriaxone and ceftazidime. The questionnaire showed that nursing staff did not follow guidelines for medical care of patients with urinary catheters. It can be concluded that poor hygienic and epidemiological conditions, as well as irrational use of antibiotics contribute to uncontrolled development of urinary tract infections in catheterized patients.