Prevalence and risk factors for highly resistant microorganisms in urinary isolates from newly admitted patients in the National Rehabilitation Center, Korea.
OBJECTIVE
To determine the prevalence of, and risk factors for, highly resistant microorganisms (HRMO) in urinary isolates from newly admitted patients in a rehabilitation hospital.


METHODS
A total of 906 patients transferred to a rehabilitation hospital from other hospitals.


METHODS
A screening study was performed from June 2012 through May 2013. Urine samples were collected from transferred patients on admission day.


RESULTS
Of the total of 916 patients, 148 (16.2%) displayed growth of HRMO in urine cultures. Gram-negative species had a higher number and ratio of HRMO compared with Gram-positive species (141/325 (43.4%) vs 9/97 (9.3%)). Multivariate analysis revealed that age over 60 years, female sex, recent surgery, and use of urinary catheters were risk factors for HRMO among all admitted patients. Even among patients with bacteriuria, recent surgery and an indwelling urinary catheter were significant risk factors for HRMO colonization. The odds ratio for prevalence of HRMO in patients with 2 or more risk factors was 4.1 (95% confidence interval 2.7-6.1), compared with those with single or no risk factors.


CONCLUSIONS
The prevalence of HRMO in rehabilitation patients was higher than expected. Routine screening of urine culture for HRMO is therefore recommended in rehabilitation patients with multiple risk factors.
Department of Internal Medicine, National Rehabilitation Center, 142-070 Seoul, Korea. sbyoon@catholic.ac.kr.
Seung Bae
SB
Yoon
D017677:Age Distribution; D001419:Bacteria / Q000302:isolation & purification; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology / Q000652:urine; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D011446:Prospective Studies; D012047:Rehabilitation Centers / Q000706:statistics & numerical data; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors; D017678:Sex Distribution; D014552:Urinary Tract Infections / Q000453:epidemiology* / Q000382:microbiology* / Q000652:urine