Intensive care unit-acquired urinary tract infections in patients admitted with sepsis: etiology, risk factors, and patterns of antimicrobial resistance

• Published in: International journal of infectious diseases 2008-05, Vol.12 (3), p.312-318
• Main Authors: Mojtahedzadeh, Mojtaba, Panahi, Yunes, Fazeli, Mohammad Reza, Najafi, Atabak, Pazouki, Marzieh, Navehsi, Bahareh Mahdi, Bazzaz, Avid, Naghizadeh, Mohammad Mehdi, Beiraghdar, Fatemeh
• Format: Article
• Language: English
• Subjects: Adult; Aged; Anti-Bacterial Agents - pharmacology; Antimicrobial resistance; Bacterial diseases; Bacterial diseases of the urinary system; Bacterial sepsis; Biological and medical sciences; Coagulase - metabolism; Cross Infection - drug therapy; Cross Infection - etiology; Drug Resistance, Bacterial; Female; Gram-Negative Bacteria - classification; Gram-Negative Bacteria - drug effects; Gram-Negative Bacteria - isolation & purification; Gram-Negative Bacterial Infections - microbiology; Human bacterial diseases; Humans; ICU-acquired; Infectious Disease; Infectious diseases; Intensive Care Units; Male; Medical sciences; MIC; Middle Aged; Nephrology. Urinary tract diseases; Pulmonary/Respiratory; Risk Factors; Sepsis; Septic patients; Staphylococcal Infections - microbiology; Staphylococcus - drug effects; Staphylococcus - enzymology; Staphylococcus - isolation & purification; Urinary system involvement in other diseases. Miscellaneous; Urinary Tract Infections - drug therapy; Urinary Tract Infections - etiology; Urinary tract. Prostate gland; Urine - microbiology; UTI
• ISSN: 1201-9712; 1878-3511
• DOI: 10.1016/j.ijid.2007.09.005

Summary Objectives The objective of the present study was to evaluate the etiology, risk factors, and patterns of antimicrobial resistance of intensive care unit (ICU)-acquired urinary tract infections (UTIs) in patients admitted with sepsis. Methods In this observational study, 100 septic patients hospitalized in a general ICU were selected. Demographic, clinical, and outcome data were obtained by chart review. Antibiotic resistance/susceptibility was determined using the minimal inhibitory concentration (MIC) technique. Results A UTI was present in 28 (28%) patients; the male to female ratio was 19:9 and the mean age of the patients was 58.71 ± 19.45 years. From the total of 28 isolates, 27 were resistant to ciprofloxacin, 23 to amikacin, 27 to meropenem, 28 to cefepime, 26 to ceftazidime, and 27 to ceftriaxone. Conclusions On the basis of our results, the rate of multidrug-resistant UTIs may be very high in some ICUs in patients admitted with sepsis. This antimicrobial susceptibility/resistance should be determined, and a special antimicrobial treatment protocol should be planned based on the results for each ICU. The use of antibiotics for treating UTIs should be guided only through this protocol because of the different spectra of pathogens and susceptibility patterns in each ICU.