Urinary tract infections and other associated factors in two Syrian hospitals: a cross-sectional study

Urinary tract infections (UTIs) cause a major burden in hospitals, mainly among the elderly, where they can increase morbidity and mortality and are a common cause of delirium. We aim to study UTIs, their inflammatory markers, and microbiology cultures in Syria.

This is a cross-sectional study conducted in two major hospitals in Damascus, Syria, on patients admitted for UTIs and urosepsis who had positive urine cultures. Our study included comorbidities such as diabetes and high blood pressure. Urine cultures symptoms, and presentation were used to determine the diagnosis of UTI/urosepsis. Having an indwelling catheter or other abnormalities was also included.

This study included 120 patients, 66 (55%) being females. The mean age of the sample was 59.5 years (SD = 11.4), with 52.2% being above 60 years of age. Urine cultures yielded 64 (53.3%) Escherichia coli, of which extended-spectrum beta-lactamases (ESBL) 16 (13.3%), and 23 (19.2%) yielded Klebsiella pneumoniae. Diabetes was significantly associated with having sepsis with the UTI (P < 0.049). Older ages, higher C-reactive protein and neutrophils ratio were significantly associated with urosepsis compared to having just a UTI. However, having an indwelling catheter, urological anatomical abnormalities and recurrent UTIs were not associated with a higher chance of urosepsis.

UTIs are a major problem and the ESBL burden is high. We need better early indicators to face this growing resistance and to improve outcomes.