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Nosocomial urinary tract infection: a microbiological study

R K Chan1, W C Lye, E J Lee

  • 1Department of Laboratory Medicine, National University Hospital, Singapore.

Annals of the Academy of Medicine, Singapore
|November 1, 1993
PubMed
Summary

Nosocomial urinary tract infections (UTIs) are common in hospitals. Klebsiella species are the leading cause, showing increased antibiotic resistance, necessitating careful antibiotic selection for effective treatment.

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Area of Science:

  • Infectious Diseases
  • Microbiology
  • Hospital Epidemiology

Background:

  • Nosocomial urinary tract infections (UTIs) contribute significantly to patient morbidity and mortality.
  • Antimicrobial resistance patterns are evolving due to broad-spectrum antibiotic use.

Purpose of the Study:

  • To investigate the bacteriological profile of nosocomial UTIs.
  • To determine the antibiotic sensitivity patterns of isolated pathogens.

Main Methods:

  • A one-year prospective study of 541 patients with 656 episodes of nosocomial UTI.
  • Isolation and identification of 748 organisms.
  • Analysis of complicating factors and antibiotic susceptibility.

Main Results:

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  • Klebsiella species (25.0%) were the predominant pathogens, associated with age and diabetes mellitus, and showed increasing antibiotic resistance.
  • Escherichia coli (17.7%) and Streptococcus faecalis (10.6%) were also common, with S. faecalis linked to instrumentation.
  • Pseudomonas species (8.6%) were sensitive to ceftazidime and amikacin, associated with malignancies and immunosuppression.

    • Conclusions:

    • Klebsiella species are a major cause of nosocomial UTIs with concerning resistance trends.
    • Urogenital instrumentation and diabetes mellitus are key risk factors.
    • Tailored antibiotic strategies are crucial given the observed resistance patterns.