Journals / Mikrobiyoloji Bülteni / 2007 / Cilt: 41 - Sayı: 1
Nosocomial urinary tract infections in the intensive care unit patients
- Journal
- Mikrobiyoloji Bülteni
- Pages
- 39–49
- DOI
- —
Abstract
The aim of this prospective study was to determine the frequency of nosocomial urinary tract infections (UTI) and risk factors in intensive care unit patients. A total of 110 patients were included in the study, and UTI developed in 3 9 . 1% of them. The mean age of patients with UTI (53.6±20.0 yrs) was found higher than the patients without UTI (39.7±22.2 yrs), (p<0.01), whereas there was no gender associated difference between these two groups (p>0.01). No patient had developed symptoms suggesting UTI. All of the UTI has developed in patients with urinary catheter. Infections occurred in 72.2% of the patients with catheter lasting for seven days or more, and 24.3% of those lasting less than seven days (p<0.001). The UTI development rate was found as 31.3% in the patients who had been using antibiotics, while this ratio was 50% in those who had not used antibiotics (p<0.05). Pyuria was detected in 8 6 . 1% and 17.9% of the patients with and without UTI, respectively (p<0.001). Detection of bacteria in urine by the examination of Gram stained preparations, and the tests of peripheral blood leucocyte counting and CRP levels were not found sensitive and specific for nosocomial UTI. The prevalence of UTI increased gradually by the duration of hospitalization. The most frequently isolated microorganisms were found, as Candida (27.2%), Escherichia coli (27.2%) and staphylococci (12.9%). Since nosocomial UTI which are important causes of morbidity in intensive care unit patients, are difficult to diagnose and treat, more efforts should be used for preventive measures.
Özet
Bu çalışma, yoğun bakım ünitesinde yatmakta olan hastalarda nozokomiyal üriner sistem enfeksiyonlarının sıklığı ve risk faktörlerini saptamak amacıyla prospektif olarak planlanmıştır. Çalışmaya 110 hasta dahil edilmiş, bunların %39.1'inde üriner sistem enfeksiyonu geliştiği belirlenmiştir. Enfeksiyon gelişen hastalarda yaş ortalaması (53.6±20.0 yıl), gelişmeyenlerden anlamlı olarak daha yüksek (39.7±22.2 yıl) bulunmuş (p 0.01). Üriner sistem enfeksiyonlarının tamamı üriner kateteri olan hastalarda ortaya çıkmış ve olgularda enfeksiyona özgü semptomlar tespit edilmemiştir. Kateteri yedi gün veya daha fazla kalan hastaların %72.2'sinde, yedi günden az kalanların ise %24.3'ünde (p ), Escherichia coli (%27.2) ve stafilokoklar (%12.9) izole edilmiştir. Sonuç olarak, yoğun bakım hastalarında önemli bir morbidite nedeni olan nozokomiyal üriner sistem enfeksiyonlarında tanı ve tedavi zorlukları nedeniyle, bu enfeksiyonların önlenmesine yönelik çabalara ağırlık verilmesi gerektiği kanısına varılmıştır.