Srpski arhiv za celokupno lekarstvo 2016 Volume 144, Issue 9-10, Pages: 490-496
https://doi.org/10.2298/SARH1610490D
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Risk factors for healthcare-acquired urinary tract infections caused by multi-drug resistant microorganisms
Đorđević Zorana M. (Clinical Center Kragujevac, Epidemiology Department, Kragujevac)
Folić Marko M. (Faculty of Medical Sciences, Kragujevac + Clinical Center Kragujevac, Clinical Pharmacology Department, Kragujevac)
Gavrilović Jagoda (Clinical Center Kragujevac, Clinic for Infectious Diseases, Kragujevac)
Janković Slobodan M. (Faculty of Medical Sciences, Kragujevac + Clinical Center Kragujevac, Clinical Pharmacology Department, Kragujevac)
Introduction. Healthcare-acquired urinary tract infections (HAUTI) make up to
40% of all healthcareacquired infections and contribute significantly to
hospital morbidity, mortality, and overall cost of treatment. Objective. The
aim of our study was to investigate possible risk factors for development of
HAUTI caused by multi-drug resistant pathogens. Methods. The prospective
case-control study in a large tertiary-care hospital was conducted during a
five-year period. The cases were patients with HAUTI caused by multi-drug
resistant (MDR) pathogens, and the controls were patients with HAUTI caused
by non-MDR pathogens. Results. There were 562 (62.6%) patients with MDR
isolates and 336 (37.4%) patients with non-MDR isolates in the study. There
were four significant predictors of HAUTI caused by MDR pathogens:
hospitalization before insertion of urinary catheter for more than eight days
(ORadjusted = 2.763; 95% CI = 1.352-5.647; p = 0.005), hospitalization for
more than 15 days (ORadjusted = 2.144; 95% CI = 1.547-2.970; p < 0.001),
previous stay in another department (intensive care units, other wards or
hospitals) (ORadjusted = 2.147; 95% CI = 1.585-2.908; p < 0.001), and cancer
of various localizations (ORadjusted = 2.313; 95% CI = 1.255-4.262; p =
0.007). Conclusion. Early removal of urinary catheter and reduction of time
spent in a hospital or in an ICU could contribute to a decrease in the rate
of HAUTI caused by MDR pathogens.
Keywords: urinary tract infections, nosocomial infections, multiple antibacterial drug resistance, risk factors