title: Healthcare-associated infections in a department of urology: incidence and patterns of antibiotic resistance.
abstract: OBJECTIVE
  Healthcare-associated infections (HAIs) constitute a potentially severe complication which implies higher costs. A full knowledge of their microbiological characteristics and risk factors is of paramount importance for adequate management. The purpose of this study was to carry out an analysis of HAIs in patients admitted to a department of urology.
  
  
  METHODS
  Between November 2011 and October 2012, a prospective observational study was carried out analysing HAIs in patients admitted to the urology department of a tertiary care university hospital in Spain, reviewing the incidence and types of HAIs, the microorganisms isolated and patterns of resistance to antibiotics. Risk factors for HAIs were also evaluated.
  
  
  RESULTS
  HAIs were seen in 110 (6.5%) out of 1701 patients. Hypertension, a higher American Society of Anesthesiologists (ASA) score and surgery showed a statistical association with a higher risk of HAIs, and patients who underwent radical cystectomy had a high incidence of HAIs (10 out of 14). The most common HAIs were urinary tract infections (66.1%), followed by surgical site infections (16.5%), intra-abdominal abscesses (10.4%) and venous catheter-associated bacteraemia (6.1%). The most frequently isolated microorganisms were Escherichia coli (31.8%), then Enterococcus (17.6%) and Pseudomonas (12.9%). Escherichia coli showed resistance rates of 48.1% for ampicillin/amoxicillin plus β-lactamase inhibitor, 51.9% for fluoroquinolones, and 33.3% were extended-spectrum β-lactamase-producing E. coli. Pseudomonas aeruginosa showed a resistance rate of 36.4% for fluoroquinolones and carbapenems.
  
  
  CONCLUSIONS
  HAIs usually occur in patients with risk factors. Radical cystectomy is associated with a high incidence of HAIs. Microorganisms associated with HAIs show high rates of resistance, which must be taken into account when selecting appropriate antibiotic therapy.
authors.affiliation: Department of Urology, Hospital Universitario 12 de Octubre , Madrid , Spain.
authors.forename: José
authors.initials: J
authors.lastname: Medina-Polo
authors.forename: Estíbaliz
authors.initials: E
authors.lastname: Jiménez-Alcaide
authors.forename: Lucía
authors.initials: L
authors.lastname: García-González
authors.forename: Félix
authors.initials: F
authors.lastname: Guerrero-Ramos
authors.forename: Santiago
authors.initials: S
authors.lastname: Pérez-Cadavid
authors.forename: Ana
authors.initials: A
authors.lastname: Arrébola-Pajares
authors.forename: Raquel
authors.initials: R
authors.lastname: Sopeña-Sutil
authors.forename: Raúl
authors.initials: R
authors.lastname: Benítez-Salas
authors.forename: Rafael
authors.initials: R
authors.lastname: Díaz-González
authors.forename: Ángel
authors.initials: Á
authors.lastname: Tejido-Sánchez
mesh_terms: D000368:Aged; D003428:Cross Infection / Q000188:drug therapy* / Q000453:epidemiology* / Q000382:microbiology; D004352:Drug Resistance, Microbial; D005260:Female; D006748:Hospital Departments; D006785:Hospitals, University; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D014572:Urology