Acquired Urinary Tract Infection in the Public Hospital

Objective: The aim of the study was to determine the prevalence of UTIs in Syria, determine micro-organisms responsible for UTI, their antibiotic sensitivities and to describe the risk factors of nosocomial urinary tract infections. Subjects and Methods: This was a prospective surveillance study including cases of NUTI in intensive care units and various inpatient clinics. This study was carried out between April 2015 and January 2016 The following information was recorded: patients’ age, gender, presence of urinary catheter, intensive care unit admission, duration of hospital stay, type of organisms isolated and their antimicrobial susceptibility. The diagnosis of NUTI was based on criteria established by the Centers for Disease Control, Atlanta. Mini Api and conventional culture methods were used to determine the causative agents. The agents were isolated on eosin methylene blue agar and blood agar. Statistical analyses of data were by Pearson test and logistic regression. Results: In this study, 40(20%) nosocomial urinary tract infections (NUTIs) were determined in 200 patients, 10 NUTI patients (25%) were male and 30 (75%) were female. The most frequently isolated micro-organism was Escherichia coli (38.09%) followed by Streptococcus spp (23.8%), Proteus mirabilis (14.28%), Klebsiella spp (9.52%) and Pseudomonas spp (9.52%). The most effective antibiotics against Gram-negative bacteria were found to be imipenem and levofloxacin. Conclusions: This study indicated that to reduce the incidence of NUTI, it was important to take factors that can be managed into consideration (to avoid unnecessary urethral catheterization, to choose narrow spectrum antibiotics according to antibiotic sensitivities, to investigate regularly the causative micro-organisms and their resistance patterns and to update the treatment protocols).