BACKGROUND: Urinary tract infections (UTIs) are a common disease with a high burden on the healthcare industry. A systematic exploration is necessary of the organisms that cause UTIs, to improve empirical management of patients with acute illness before culture results are obtained. The prevalence of these organisms, both in immunocompetent and immunocompromised patients in Saudi Arabia, needs further clarification.
METHODS: This is a cross-sectional analysis reviewing the charts of patients visiting the emergency department of, and those admitted to, a tertiary hospital in Saudi Arabia during the month of July-August 2021.
RESULT: The total number of participants was 199, with a mean age of 55.8 years (SD=20.02), ranging from 14 to 97 years. 61.8% of patients were immunocompromised, and one-third were from the oncology wards. 40.7% (n=81) were diabetics and 8.54% (n=17) had CKD/ESRD. Females were 25% more likely than males to acquire Candida infections, while Pseudomonas aeruginosa was 26.7% more prevalent in males. Nevertheless, mixed gram-negative bacteria caused the most UTIs, in 40.20% (n=80) of cases, followed by Candida, 16.1% (n=32), and then mixed gram-positive bacteria, in 14.57% (n=29). This was also observed among immunocompromised patients and the subsegment of oncology patients on active chemotherapy, although with variable percentages.
CONCLUSION: This study demonstrates that patients’ immune status is the main determinant of the causative organism of UTIs. The treatment threshold for Candida in diabetic patients and those with CKD/ESRD should be lower, especially when they require admission.
Clinical Efficacy and Cost Analysis of Antibiotics for Treatment of Uncomplicated Urinary Tract Infections in the Emergency Department of a Tertiary Hospital in Saudi Arabia
