Abstract
Urinary tract infections (UTI) cause a great number of morbidity and mortality. These infections are serious complications in pregnancy, patients with diabetes, polycystic kidneys disease, sickle cell anaemia, kidney transplant and in patients with functional or structural anomalies of the urinary tract. The aim of this investigation was to determine a dominant causative agents of UTI and some of the clinical and laboratory characteristics of acute community-acquired UTI in adult hospitalised patients. We studied 200 adult patients with acute community-acquired UTI hospitalised in the Clinic for Infectious Diseases Tuzla from January 2006 to December 2007. The patients were divided into two groups: a group of patients with E. coli UTI (147) and a group of patients with non-E. coli UTI (53). In these two groups, the symptoms and signs of illness, blood test and urine analysis results were analysed. Our results have shown that the patients with E. coli UTI frequently had fever higher than 38,5 degrees C (p<0,0001), chills (p=0,0349), headache (p=0,0499), cloudy urine (p<0,0001), proteinuria (p=0,0011) and positive nitrite-test (p=0,0002). The patients with non-E. coli UTI frequently had fever lower than 38,5 degrees C (p<0,0001) and urine specific gravity <1015 (p=0,0012). There was no significant difference in blood test results between patients with E. coli and non-E. coli UTI. These clinical and laboratory findings can lead us to early etiological diagnosis of these UTI before urine culture detection of causative agents, which takes several days. Early etiological diagnosis of the E. coli and non-E. coli UTI is necessary for an urgent administration of appropriate empirical antibiotic treatment. This is very important in prevention of irreversible kidney damage, prolonged treatment, complications, as well as recidives and chronicity of the illness.
Highlights
Materials and MethodsPatients patients older than years of age, of both sexes, with community-acquired Urinary tract infections (UTI), serious clinical presentation and unsuccessful prior outpatient treatment, who have been hospitalised in the Clinic for Infectious Diseases at the University Clinical Centre Tuzla from January to December were enrolled in this prospective study
All patients had clinical and laboratory characteristics of UTI, with ambulatory or hospital findings of significant bacteriuria in the performed urine culture. Since it is symptomatic UTI, we found that significant bacteriuria was ≥ 3 bacteria/ml of urine. e patients with nosocomial UTI, other acute infections and patients without significant bacteriuria in the performed urine culture were excluded from this study
Causative agents of UTI were defined according to the results of the urine cultures
Summary
Patients patients older than years of age, of both sexes, with community-acquired UTI, serious clinical presentation and unsuccessful prior outpatient treatment, who have been hospitalised in the Clinic for Infectious Diseases at the University Clinical Centre Tuzla from January to December were enrolled in this prospective study. All patients had clinical and laboratory characteristics of UTI, with ambulatory or hospital (up to hours after admission) findings of significant bacteriuria in the performed urine culture. Since it is symptomatic UTI, we found that significant bacteriuria was ≥ 3 bacteria/ml of urine. E patients with nosocomial UTI, other acute infections and patients without significant bacteriuria in the performed urine culture were excluded from this study Since it is symptomatic UTI, we found that significant bacteriuria was ≥ 3 bacteria/ml of urine. e patients with nosocomial UTI, other acute infections and patients without significant bacteriuria in the performed urine culture were excluded from this study
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