doiSerbia

Urinary tract nosocomial infections at the Clinical centre in Kragujevac

Đorđević Zorana (Klinički centar, Kragujevac)
Ilić Milena (Medicinski fakultet, Kragujevac)

Introduction. Urinary tract infections are the most frequent hospital infections and account for about 40% of total hospital infections. The main risk factor for their development is the use of catheters. Objective. Assessment of basic epidemiological and etiological characteristics of nosocomial urinary tract infections (NUTIs) and investigation of differences in risk factors among the patients with NUTIs with and without the urinary catheter. Methods. The study comprised patients treated in chosen units/ of the Clinical Center in Kragujevac, in whom NUTI was registered during 2009. Differences in risk factors for NUTIs between the catheterized and uncatheterized patients were tested by the logistic regression analysis. Results. NUTIs was registered in 162 patients whose average age was 66.2±13.5 years with approximately equal gender participation (51.2% men and 48.8% women). Almost three quarters of the patients with NUITs had indwelling urinary catheter, 12.0±7.7 days on average (from 1 to 39 days). In the patients with urinary catheter, the risk for NUITs was significantly positively associated with emergency admission to hospital treatment (p=0.0185). The uncatheterized patients had a significant frequency of malignant tumours comparing to the patients with a urinary catheter (p=0.039). The compared groups did not differ in other risk factors. The most frequently isolated microbial agents was Klebsiella spp (37.3%), then Pseudomonas aeruginosa (14.1%) and Proteus mirabilis (11.9%). Most of the bacteria showed a great level of resistance to frequently used antibacterial drugs, even up to 100%. Conclusion. It is necessary to define national recommendations for the prevention and control of NUTIs in the future.

Keywords: nosocomial urinary tract infection, urinary catheter, risk factors, antibiotics resistance