Decreasing Nosocomial Urinary Tract Infection in a Large Academic Community Hospital

Objective. Plasmid-mediated quinolone resistance (PMQR) plays an important role in the development of clinical resistance to quinolone. The aim of this study was to investigate PMQR determinants among extended-spectrumβ-lactamases- (ESBL-) producingKlebsiella pneumoniaerecovered from patients with nosocomial urinary tract infection (UTI).Methods. A total of 247 ESBL-producingK. pneumoniaeisolates were collected from 750 patients with UTI. ESBL production was confirmed by double disc synergy test and combined disc diffusion test. The prevalence of PMQR determinants among ESBL-producingK. pneumoniaewas assessed using PCR method.Results. The rates of resistance to antimicrobial agents in present study varied from 14.2% to 98.8%. In comparison with other PMQR genotypes, the frequency ofaac(6′)-Ib(68.8%) was strikingly high. Of the 247 isolates tested,qnrA, qnrB, qnrS,andqepAgenes were present in 3.6%, 1.6%, 1.2, and 2%, respectively.oqxAandoqxBwere detected in 56.7% and 54.6% of isolates. The predominant coexisting ESBL and PMQR profile among our isolates includedblaCTX-Mandaac(6′)-Ib, oqxA, oqxB(28.3%) andblaTEM,blaSHVandaac(6′)-Ib, oqxA,andoqxB(19.4%) profile. Conclusion. Given the linkage observed between resistance to quinolones and beta lactam antibiotics, therapeutic protocol with fluoroquinolones and beta lactam antibiotics should be seriously revised in Tehran hospitals.

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The Difference of Nosocomial Urinary Tract Infection Risk Based on Chateterization Urine, Age, and Diabetes Mellitus

Jurnal Berkala Epidemiologi ◽

10.20473/jbe.v3i22015.205-216 ◽

2015 ◽

Vol 3 (2) ◽

pp. 205 ◽

Cited By ~ 1

Author(s):

Edel Weisela Permata Sari ◽

Prijono Satyabakti

Keyword(s):

Diabetes Mellitus ◽

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

Infection Risk ◽

Case Control ◽

Risk Difference ◽

Independent Variables ◽

Nosocomial Urinary Tract Infection ◽

The Difference

Nosocomial urinary tract infection is common occurs in patients with indwelling urinary chateter. Factors that caused nosocomial urinary tract infection are host, agent, and chateterization urine. The aim of this research was to analyze risk difference nosocomial urinary tract infection based on chateterization urine, age, and diabetes mellitus (DM). This study used case control with sample size 20 for each group. Case sample was patients who diagnosed urinary tract infection, while control sampel was patients who not diagnosed urinary tract infection in Haji Hospital Surabaya on 2013 until 2014. The independent variables were duration of chateterization, frequency of chateterization, age, and DM, while dependent variable was nosocomial urinary tract infection. Those variables was analyze with risk difference (RD) in Epi Info. The result showed that risk difference nosocomial urinary tract infection based on duration of chateterization is RD = 0,52 it means if changing chateter was done every seven days used, it can prevent 0,52 from 0,71 or 73,53% urinary tract infection cases, frequency of chateterization is RD = 0,43956 it means if decrease frequency of chateterization until one time used, it can prevent 0,44 from 0,79 or 55,94% urinary tract infection cases, age is RD = 0,40 it means if insertion of urine catheter as indicated and right procedure in patient with >55 old it can prevent 0,40 from 0,68 or 59,26% urinary tract infection cases, and DM is RD = 0,42 it means if preventing toward DM, it can prevent 0,42 from 0,75 or 55,56% urinary tract infection cases.Keyword: chateterization urine, age, diabetes mellitus, nosocomial urinary tract infection

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