Profile of Urinary Tract Infections in the Elderly in the Internal Medicine Department of the University Hospital Center of Point G, Bamako, Mali

Introduction: Urinary tract infections are the most frequent healthcare associated infections, being related to both high costs and morbidity. Our intention was to carry out an epidemiological characterization of hospital acquired urinary tract infections that occurred in an internal medicine department of a Portuguese hospital.Material and Methods: Retrospective cohort study (historic cohort). Data were analysed from a systematic random sample of 388 patients, representative of the 3492 admissions occurred in 2014 in that department.Results: One in four patients underwent the placement of a bladder catheter [24.7% (n = 96); 95% CI: 20% - 29%], 36.5% (95% CI: 33% - 48%) of which in the absence of clinical criteria for that procedure. The global cumulative incidence rate for nosocomial urinary tract infections was 4.6% (95% CI: 2.5% - 6.7%). Most hospital acquired urinary tract infections (61.1%) were related to bladder catheter use. We quantified 3.06 infections / 1000 patient-days and 14.5 infections / 1000 catheter-days. Catheter associated urinary tract infection occurred at an early stage of hospitalization. The vast majority of patients (66.7%) that developed a catheter associated urinary tract infection were subjected to bladder catheter placement at emergency department. Seventy one per cent of catheter associated urinary tract infection occurred in patients that were subjected to bladder catheter placement without criteria.Discussion: These results point to an excessive and inadequate use of urinary catheters, highlighting the need for judicious use taking into account the formal clinical indications. The incidence of catheter associated urinary tract infection is similar to what we found in other studies. Nevertheless we found a very high incidence density per catheter-days that may foresee a problem probably related to the absence of early withdrawal of the device, and to both bladder catheter placement and maintenance practices. A significant part of catheter associated urinary tract infection occurred in patients that had the bladder catheter placed in the emergency department, before the admission to the internal medicine ward, which highlights the need to assess the urinary catheterization practices in those departments.Conclusion: The high rate of catheter associated urinary tract infection that occurred in the absence of bladder placement indication reinforces the need to implement prevention strategies that contemplate the reduction of its use. Emergency departments should be part of quality improvement projects in this area. Causes for the early onset of catheter associated urinary tract infection in this cohort should be investigated.

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Prevalence and Antimicrobial Susceptibility Patterns of Bacterial Pathogens in Urinary Tract Infections in University Hospital of Campania “Luigi Vanvitelli” between 2017 and 2018

Antibiotics ◽

10.3390/antibiotics9050215 ◽

2020 ◽

Vol 9 (5) ◽

pp. 215 ◽

Cited By ~ 6

Author(s):

Veronica Folliero ◽

Pina Caputo ◽

Maria Teresa Della Rocca ◽

Annalisa Chianese ◽

Marilena Galdiero ◽

...

Keyword(s):

Urinary Tract ◽

Urinary Tract Infections ◽

The Elderly ◽

University Hospital ◽

Bacterial Strains ◽

Gram Positive ◽

Antibiotic Resistant ◽

Gram Negative ◽

Flight Mass Spectrometry ◽

Tract Infections

Urinary tract infections (UTIs) are the most common and expensive health problem globally. The treatment of UTIs is difficult owing to the onset of antibiotic-resistant bacterial strains. The aim of this study was to define the incidence of infections, identify the bacteria responsible, and identify the antimicrobial resistance profile. Patients of all ages and both sexes were included in the study, all admitted to University Hospital of Campania “Luigi Vanvitelli”, between January 2017 and December 2018. Bacterial identification and antibiotic susceptibility testing were performed using matrix assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) and Phoenix BD. Among the 1745 studied patients, 541 (31%) and 1204 (69%) were positive and negative for bacterial growth, respectively. Of 541 positive patients, 325 (60%) were females, while 216 (39.9%) were males. The largest number of positive subjects was recorded in the elderly (>61 years). Among the pathogenic strains, 425 (78.5%) were Gram-negative, 107 (19.7%) were Gram-positive, and 9 (1.7%) were Candida species. The most isolated Gram-negative strain is Escherichia coli (E. coli) (53.5%). The most frequent Gram-positive strain was Enterococcus faecalis (E. faecalis) (12.9%). Gram-negative bacteria were highly resistant to ampicillin, whereas Gram-positive bacteria were highly resistant to erythromycin.

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P0695 URINARY TRACT INFECTIONS: THE MICROBIOLOGICAL POPULATION OF AN INTERNAL MEDICINE DEPARTMENT AND THE EVOLUTION OF RESISTANCE TO ANTIBIOTICS OVER A 5 YEAR PERIOD

European Journal of Internal Medicine ◽

10.1016/s0953-6205(09)60714-7 ◽

2009 ◽

Vol 20 ◽

pp. S227

Author(s):

Vitor Fagundes ◽

Andre Pauperio ◽

Iva Guimarães ◽

João Pinto ◽

Anabela Silva ◽

...

Keyword(s):

Internal Medicine ◽

Urinary Tract ◽

Urinary Tract Infections ◽

Medicine Department ◽

Internal Medicine Department ◽

Resistance To Antibiotics ◽

Evolution Of Resistance ◽

Tract Infections

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URINARY INFECTION AT DEPARTMENT OF UROLOGY OF HUE UNIVERSITY OF MEDICINE AND PHARMACY HOSPITAL

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2018.3.16 ◽

2018 ◽

pp. 100-108

Author(s):

Dinh Khanh Le ◽

Dinh Dam Le ◽

Khoa Hung Nguyen ◽

Xuan My Nguyen ◽

Minh Nhat Vo ◽

...

Keyword(s):

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

Urinary Tract Infections ◽

Urine Culture ◽

Clinical Manifestations ◽

University Hospital ◽

E Coli ◽

Positive Urine ◽

Tract Infections

Objectives: To investigate clinical characteristics, bacterial characteristics, drug resistance status in patients with urinary tract infections treated at Department of Urology, Hue University Hospital. Materials and Method: The study was conducted in 474 patients with urological disease treated at Department of Urology, Hue Universiry Hospital from July 2017 to April 2018. Urine culture was done in the patients with urine > 25 Leu/ul who have symptoms of urinary tract disease or infection symptoms. Patients with positive urine cultures were analyzed for clinical and bacterial characteristics. Results: 187/474 (39.5%) patients had symptoms associated with urinary tract infections. 85/474 (17.9%) patients were diagnosed with urinary tract infection. The positive urine culture rate was 45.5%. Symptoms of UTI were varied, and no prominent symptoms. E. coli accounts for the highest proportion (46.67%), followed by, Staphycoccus aureus (10.67%), Pseudomonas aeruginsa (8,0%), Streptococcus faecali and Proteus (2.67%). ESBL - producing E. coli was 69.23%, ESBL producing Enterobacter spp was 33.33%. Gram-negative bacteria are susceptible to meropenem, imipenem, amikacin while gram positive are vancomycin-sensitive. Conclusions: Clinical manifestations of urinary tract infections varied and its typical symptoms are unclear. E.coli is a common bacterium (46.67%). Isolated bacteria have a high rate of resistance to some common antibiotics especially the third generation cephalosporins and quinolones. Most bacteria are resistant to multiple antibiotics at the same time. Gram (+) bacteria are susceptible to vancomycin, and gram (-) bacteria are susceptible to cefoxitin, amikacin, and carbapenem. Key words: urinary tract infection

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