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[Nosocomial urinary tract infections in patients with prolonged bladder catheterization: un unsolved problem]
A Domínguez Castellano1, R Cerro González, J L García López
1Servicio de Medicina Interna, Hospital San Lázaro, Sevilla.
Abstract:
Urinary tract infection (UTI) is the primary cause of hospitalary infection. We have prospectively studied during a 8-month period, 94 episodes of UTI in 61 patients with a mean age of 77 years and with a high percentage of vesical sounding (70.5%). The most frequent cause of sounding was urinary incontinence (74%) and in just 15% of all cases, there was a strict urological indication. The association fever/sounding was statistically significant (p < 0.05) and, when analyzing the prognosis factors, we observed that patients who had a significantly higher risk were those with vesical sounding (p < 0.05), fever equal to or higher than 38 degrees C and/or Pseudomonas aeruginosa isolated in their uroculture (p < 0.01). Among the microorganisms isolated, P. aeruginosa ranked in first place, followed by E. Coli. The most sensitive antibiotics in these patients were the aminoglycosides (tobramycin or gentamycin), cephtacidime and aztreonan. Finally, the percentage of coincidence between the microorganisms isolated in the uroculture and in the infections of other patients sharing the same room is significantly higher (p < 0.01) in patients with vesical sounding than in patients without it, suggesting a transmission role of the health staff.
Insights
Urinary tract infections (UTIs) are common in elderly patients, especially with bladder catheterization. Vesical sounding significantly increases UTI risk, with Pseudomonas aeruginosa being a key pathogen.
Area of Science:
- Infectious Diseases
- Geriatrics
- Urology
Context:
- Urinary tract infections (UTIs) are a leading cause of hospital-acquired infections.
- Elderly patients (mean age 77) with high rates of vesical sounding (70.5%) were studied.
- Urinary incontinence was the primary reason for bladder sounding (74%).
Purpose:
- To investigate risk factors and causative agents of UTIs in elderly patients undergoing vesical sounding.
- To identify effective antibiotic treatments for UTIs in this population.
- To explore potential transmission routes of hospital-acquired UTIs.
Summary:
- A prospective study analyzed 94 UTI episodes in 61 elderly patients.
- Vesical sounding, fever (≥38°C), and Pseudomonas aeruginosa isolation were significant UTI risk factors (p < 0.05).
- Aminoglycosides, ceftazidime, and aztreonam showed high sensitivity against isolated pathogens, with P. aeruginosa and E. coli being most frequent.
Impact:
- Findings highlight vesical sounding as a critical risk factor for hospital-acquired UTIs in the elderly.
- Results guide antibiotic selection and infection control strategies.
- Increased UTI pathogen transmission in shared rooms among patients with vesical sounding suggests healthcare staff role.