Intensive care unit-acquired urinary tract infections in patients admitted with sepsis: etiology, risk factors, and patterns of antimicrobial resistance.
OBJECTIVE
The objective of the present study was to evaluate the etiology, risk factors, and patterns of antimicrobial resistance of intensive care unit (ICU)-acquired urinary tract infections (UTIs) in patients admitted with sepsis.


METHODS
In this observational study, 100 septic patients hospitalized in a general ICU were selected. Demographic, clinical, and outcome data were obtained by chart review. Antibiotic resistance/susceptibility was determined using the minimal inhibitory concentration (MIC) technique.


RESULTS
A UTI was present in 28 (28%) patients; the male to female ratio was 19:9 and the mean age of the patients was 58.71+/-19.45 years. From the total of 28 isolates, 27 were resistant to ciprofloxacin, 23 to amikacin, 27 to meropenem, 28 to cefepime, 26 to ceftazidime, and 27 to ceftriaxone.


CONCLUSIONS
On the basis of our results, the rate of multidrug-resistant UTIs may be very high in some ICUs in patients admitted with sepsis. This antimicrobial susceptibility/resistance should be determined, and a special antimicrobial treatment protocol should be planned based on the results for each ICU. The use of antibiotics for treating UTIs should be guided only through this protocol because of the different spectra of pathogens and susceptibility patterns in each ICU.
Mojtahedzadeh
Mojtaba
M
Pharmaceutical Research Center, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.
Panahi
Yunes
Y
Fazeli
Mohammad Reza
MR
Najafi
Atabak
A
Pazouki
Marzieh
M
Navehsi
Bahareh Mahdi
BM
Bazzaz
Avid
A
Naghizadeh
Mohammad Mehdi
MM
Beiraghdar
Fatemeh
F
D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D003030:Coagulase / Q000378:metabolism; D003428:Cross Infection / Q000188:drug therapy / Q000209:etiology*; D024881:Drug Resistance, Bacterial; D005260:Female; D006090:Gram-Negative Bacteria / Q000145:classification / Q000187:drug effects* / Q000302:isolation & purification; D016905:Gram-Negative Bacterial Infections / Q000382:microbiology; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D018805:Sepsis; D013203:Staphylococcal Infections / Q000382:microbiology; D013210:Staphylococcus / Q000187:drug effects* / Q000201:enzymology / Q000302:isolation & purification; D014552:Urinary Tract Infections / Q000188:drug therapy / Q000209:etiology*; D014556:Urine / Q000382:microbiology
D000900:Anti-Bacterial Agents; D003030:Coagulase