Nosocomial Urinary Tract Infections in a Tertiary Hospital; Preliminary Study of Antibiotics Susceptibility Testing and Pathogen Types

Abstract

Introduction: Nosocomial urinary tract infections (NUTIs) are the most frequently acquired infection worldwide. This retrospective study aimed to determine the type of pathogens and antibiotic susceptibility testing in hospital-acquired UTIs. Methods: Information from the recorded official database of the Alzahra, Isfahan/Iran tertiary specialist hospital was obtained. Urine was collected based on two methods: 1) central stream and 2) with a urinary catheter in place. The incidence of acquired infections (NUTIs-SUTI; Code 55) was described as a percentage. The statistical calculations were conducted using the statistical software. There were 2210 recorded NUTIs comprised of 1115 males and 1095 females. Among the total recorded data with NUTIs, 251 records were associated with deaths. The distribution of hospital stays in 57% was between 2-30 days. Available data showed that Candida (23%), Escherichia coli (22%), Klebsiella pneumonia (17%), and Enterococcus (faeciumfecalis; 12%) were the most ranked microorganisms in patients with NUTIs. Resulsts: Sensitivity tests for Escherichia coli associated with different antibiotics were ranked as; 1) Meropenem (n= 160; S= 66%), 2) Vancomycin (n= 53; S= 64%), 3) Piperacillin/Tazobactam (n= 144; S= 58%), 4) Amikacin (n= 146; S= 44%), 5) Co-trimoxazole (n= 153; S=42%), 6) Penicillin (n=79; S=41%), 7) Cefepime (n=143; S=31%), 8) Ceftazidime (n=142; S=31%), 9) Ciprofloxacin (n=204; S=25%). Sensitivity tests for Klebsiella pneumonia associated with different antibiotics were ranked as; 1) Piperacillin/Tazobactam (n= 110; S= 55%), 2) Amikacin (n= 125; S= 55%), and 3) Ciprofloxacin (n=177; S=23%). Sensitivity tests for Enterococcus (faecium-fecalis) associated with different antibiotics were ranked as; 1) Piperacillin/Tazobactam (n= 79; S= 62%), 2) Amikacin (n= 83; S= 64%) and 3) Ciprofloxacin (n=120; S=30%). Conclusion: Within the population studied, while Ciprofloxacin showed less than 30% sensitivity, Piperacillin/Tazobactam and Amikacin exhibited a sensitivity of more than 50% regarding Escherichia coli, Klebsiella pneumonia, and Enterococcus (faecium-fecalis) need further evidence-based investigations