Retrospective analysis of pathogens isolated in urinary cultures taken from patients hospitalized at the Department of Nephrology in 2010 and their antimicrobial resistance
Keywords:
urinary tract infection, antimicrobial resistance, inpatient UTIsAbstract
Introduction. Urinary tract infections ( UTIs) are ones of the most common infectious diseases and one of the most frequent reason of medical appointment and hospitalization. UTIs are also the most common clinical type of infectious diseases among patients treated in hospitals, constituting about 40-50% of all infections among inpatient adults and more than 90% among patient hospitalized in nephrology and urology wards. Knowledge about bacterial and fungal microorganisms causing UTIs among hospitalized patients and their antibiotic sensitivity is essential to order effective antibacterial therapy.
Aim. The purpose of the study was to indentify microorganisms, that were isolated in urinary samples taken from patients hospitalized in Nephrology Department in 2010 and to assess their antimicrobial resistance in vitro.
Material and methods. The 539 examined urinary samples were taken from patients hospitalized in Nephrology Department in Lublin in 2010. The urinary samples were analyzed with Vitek 2 Compact device of BioMeriux, that is fully automatic noninvasive system to indentify microorganisms and assess their antibiotics sensitivity.
Results. From 539 urinary samples taken from patients hospitalized in Nephrology Department in 2010, 226 (41.9%) were positive. Among Gram negative bacteria Escherichia coli dominated – 40.7%, subsequently strains of Enterobacter cloacae – 6.5%, Klebsiella pneumoniae ssp pneumoniae – 6.5%, Proteus mirabilis – 6.5%, Pseudomonas aeruginosa – 5.2%, Morganella morganii ssp morganii – 3.6%, Serratia marcescens – 3.2%. Other Gram negative bacteria made up totally 4.5% of isolated strains. Gram positive bacteria Enterococcus faecalis were cultured in 7.3% of urinary samples. Other detected Gram positive bacteria were: Enterococcus faecium - 4.4%, Streptococcus agalactiae – 3.6%, Staphylococcus aureus – 1.2%, and other sparser Gram positive bacteria constituted totally 3.2 %. In 3.6% analyzed urinary samples fungi were cultured- mainly Candida albicans
Conclusions. The examination of microorganisms isolated from urinary samples taken from patients hospitalized in Nephrology Department in Lublin in 2010 indicates rising amount of untypical, multiantimicrobial resistant Gram negative bacteria in pathogenesis of complicated UTIs. Gram positive bacteria causes big therapeutic problem with restricted therapeutic options bring out by rapid development of multidrug resistance. In case of UTI suspicion in inpatient person, it is difficult to predict pathogen and its antimicrobial resistance, therefore urinary culture is essential to order effective treatment. As a result of necessity of using more and more expensive , new antibiotics in treatment of UTIs, it seems to be indispensable to value again the procedure of treatment of UTIs of hospitalized patients, because it is underestimated and doesn’t cover rising costs of therapy.
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