Dominant causes of urinary tract infections at the Clinic for Infectious Diseases Tuzla.
OBJECTIVE
To determine the prevalence and antimicrobial resistance of dominant causes of urinary tract infections (UTI) in patients treated at the Clinic for Infectious Diseases, University Clinical Center Tuzla during the period January 2010 to June 2011.


METHODS
This prospective study included 438 patients divided into three groups: hospital-treated patients group (H-T), outpatient- treated group (O-T) and patients with hospital-acquired (H-A) UTI. Identification of UTI causes completed using standard microbiological methods; antimicrobial susceptibility was done by disc-diffusion method according to the CLSI.


RESULTS
E. coli was significantly more commonly isolated in females H-T, 111 (68-1%) (p=0.012) and O-T, 148 (82.7%) (p=0.006) groups, as well as in females less than 65 years from the H-T, 87 (84.5%) (p=0.000) and H-A, four (40%) (p=0.044) groups. Klebsiella pneumoniae and Pseudomonas aeruginosa were significantly more commonly isolated in male H-T, 11 (29.7%) (p=0.000) and five (13.5%) (p=0.009), and O-T UTI, two (9.5%) (p=0.009) and three (14.3%) (p=0.000) groups. E. coli showed significantly higher prevalence of resistance to amoxycillin, coamoxiclav, cefuroxime, ceftriaxone, gentamicin and co-trimoxazole in the H-A group comparing to other two groups (p less than 0.05), as well as to ampicillin, amoxycillin and cefixime in the O-T comparing to H-T group (p less than 0.05).


CONCLUSIONS
Empirical antimicrobial therapy should include coamoxiclav, nitrofurantoin, cefepime, and ceftazidime for females less than 65 years old in both H-T and H-A, cefalosporines, co-amoxiclav and nitrofurantoin in O-T UTIs; for females more than 65 years old, cefalosporines, aminoglicosides, and ciprofloxacin, in H-T and O-T UTIs. For H-A UTI in females more than 65 years as well as for all male patients antimicrobial susceptibility testing should be performed.
1Clinic for Infectious Diseases, 2Clinic for Cardiovascular Surgery, 3Department of Microbiology; University Clinical Center Tuzla, Bosnia and Herzegovina.
Dilista
D
Piljić
Humera
H
Porobić-Jahić
Dragan
D
Piljić
Nijaz
N
Tihić
Rahima
R
Jahić
Jasminka
J
Petrović
D000368:Aged; D017522:Bosnia and Herzegovina; D004352:Drug Resistance, Microbial; D005260:Female; D006782:Hospitals, Special; D006801:Humans; D008297:Male; D011446:Prospective Studies; D014552:Urinary Tract Infections / Q000188:drug therapy / Q000382:microbiology*