title: [Hospital-acquired urinary tract infections].
abstract: Urinary tract infections are responsible for 40-60% of all hospital-acquired infections. Increased age of patients and comorbid diseases render hospitalized patients more susceptible to infection. Almost 80% of hospital-acquired urinary tract infections are associated with urinary catheters, and only 5-10% of urinary infections are caused by invasive manipulations in the urogenital tract. Pathogens of hospital-acquired urinary tract infections are frequently multi-resistant, and antibiotic therapy can only be successful when the complicating factors are eliminated or urodynamic function is restored. For treatment of complicated hospital-acquired urinary tract infections, the antibiotics must exhibit adequate pharmacodynamic and pharmacokinetic properties: high renal clearance of unmetabolized form with good antimicrobial activity in both acidic and alkaline urine. For selection of empirical treatment of hospital-acquired urinary tract infections, it is necessary to evaluate localization of infection, its severity, possible isolates, and the most frequent pathogens in the department where patient is treated. The best choice for the starting the antimicrobial therapy is the cheapest narrow-spectrum effective antibiotic in the treatment of urinary tract infection until microbiological evaluation of pathogens will be received. Adequate management of urinary tract infections lowers the rate of complications, requirements for antibacterial treatment, selection of multi-resistant isolates and is cost effective.
authors.affiliation: Clinic of Intensive Therapy, Kaunas University of Medicine, Kaunas, Lithuania. daliaadukauskiene@hotmail.com
authors.forename: Dalia
authors.initials: D
authors.lastname: Adukauskiene
authors.forename: Ilona
authors.initials: I
authors.lastname: Cicinskaite
authors.forename: Astra
authors.initials: A
authors.lastname: Vitkauskiene
authors.forename: Andrius
authors.initials: A
authors.lastname: Macas
authors.forename: Ramūnas
authors.initials: R
authors.lastname: Tamosiūnas
authors.forename: Aida
authors.initials: A
authors.lastname: Kinderyte
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use; D001419:Bacteria / Q000187:drug effects / Q000302:isolation & purification; D001437:Bacteriuria / Q000175:diagnosis / Q000188:drug therapy / Q000191:economics / Q000453:epidemiology / Q000209:etiology / Q000382:microbiology / Q000503:physiopathology; D002648:Child; D003362:Cost-Benefit Analysis; D003428:Cross Infection / Q000175:diagnosis / Q000188:drug therapy / Q000191:economics / Q000453:epidemiology / Q000209:etiology / Q000382:microbiology / Q000503:physiopathology; D004352:Drug Resistance, Microbial; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D012307:Risk Factors; D012737:Sex Factors; D014546:Urinary Catheterization / Q000009:adverse effects; D014552:Urinary Tract Infections / Q000175:diagnosis / Q000188:drug therapy / Q000191:economics / Q000453:epidemiology / Q000209:etiology / Q000382:microbiology / Q000503:physiopathology; D014563:Urodynamics
chemical_list: D000900:Anti-Bacterial Agents