[Status of nosocomial urinary tract infections in the ICU: molecular epidemiology of imipenem resistant P. aeruginosa].
OBJECTIVE
This retrospective study was done to evaluate the status of nosocomial urinary tract infections and to determine the risk factors and transmission route of causal IRPA through molecular epidemiology.


METHODS
Two hundred ninety-nine of 423 patients admitted to the internal medicine and surgery ICU at a university hospital incity B had a positive urine culture. Twelve of the 299 patients who had a urinary tract infection had IRPA strains. The data was collected from November 1, 2004 to January 31, 2005. The following results were obtained after the data was analyzed using percentile and UPGMA.


RESULTS
The rate of nosocomial urinary tract infections in the ICU was 10.8%. There were 16.8 cases of infection based on the period of hospitalization. There were 16.9 cases of infection based on the use of a foley catheter. The rate of nosocomial urinary tract infection in the ICU and urinary tract infections related to IRPA were higher in patients with the following characteristics: men, old age, admission through the emergency room, longer than seven days admission, severity of admitting causes, disturbance of consciousness, hydration less than 300 cc in 24 hours, a long course of antibiotics, a long period of foley catheterization and perineal care. Most of the microorganisms that caused the urinary tract infection were gram negative bacilli, among which P. aeruginosa was found in 70 patients (18.5%) and IRPA in 12 (4.0%). Among the 12 IRPA strains that were tested with PFGE, eight showed a dice coefficient higher than 80%, suggesting a genetic relationship. They were related with the period of hospitalization in the same ICU. These patients all received direct care for a urinary tract infection.


CONCLUSIONS
Through these results, IRPA can be considered as a contributing factors to urinary tract infections thus, active preventative measures are needed by the medical staff.
Yu
Seong Mi
SM
Pusan Baek Hospital, Pusan, Korea.
Jeon
Seong Sook
SS
Kang
In Soon
IS
An
Hye Gyung
HG
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D003428:Cross Infection / Q000453:epidemiology* / Q000209:etiology / Q000382:microbiology; D024881:Drug Resistance, Bacterial; D005260:Female; D006801:Humans; D015378:Imipenem / Q000494:pharmacology*; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D011552:Pseudomonas Infections / Q000188:drug therapy / Q000453:epidemiology*; D011550:Pseudomonas aeruginosa / Q000145:classification / Q000187:drug effects / Q000235:genetics*; D012189:Retrospective Studies; D012307:Risk Factors; D014546:Urinary Catheterization; D014552:Urinary Tract Infections / Q000453:epidemiology* / Q000209:etiology / Q000382:microbiology
D000900:Anti-Bacterial Agents; D015378:Imipenem