title: Prospective study analyzing risk factors and characteristics of healthcare-associated infections in a Urology ward.
abstract: Healthcare-associated infections (HAIs) in urological patients have special features due to specific risk factors. Our objective was to evaluate the characteristics and risk factors for HAIs in patients hospitalized in a Urology ward.
  
  
  
  We evaluated prospectively, from 2012 to 2015, the incidence, types and risk factor for HAIs, microbiological and resistance patterns.
  
  
  
  The incidence of HAIs was 6.3%. The most common types were urinary infections (70.5%) and surgical site infections (22.1%). Univariate analysis showed an increased risk of HAIs among patients with American Society of Anesthesiologists physical status classification system III-IV (odds ratio [OR], 1.39; p<0.001), immunosuppression (OR, 1.80; p=0.013), previous urinary infection (OR, 4.46; p<0,001), and urinary catheter before admission (OR, 1.74; p<0.001). The surgical procedures with the highest incidence of HAIs were radical cystectomy (54.2%) and renal surgery (8.7%). The most frequently isolated microorganisms wereEscherichia coli(25.1%),Enterococcusspp. (17.5%),Klebsiellaspp. (13.5%) andPseudomonas aeruginosa(12.3%).Enterococcus spwas the most common microorganism after radical cystectomy and in surgical site infections,E. colishowed resistance rates of 53.5% for fluoroquinolones, 9.3% for amikacin. The percentage of extended-spectrum betalactamase producingE. coliwas 24.7%.Klebsiellaspp. showed resistance rates of 47.8% for fluoroquinolones, 7.1% for amikacin and 4.3% for carbapenems.Enterococcusspp showed resistance rates of 1.7% for vancomycin and;P. aeruginosaof 33.3% for carbapenems and 26.2% for amikacin.
  
  
  
  Comorbidities, previous urinary infections, and urinary catheter are risk factors for HAIs. The microorganisms most commonly isolated wereE. coli,EnterococcusandP. aeruginosa. Prospective monitoring may decrease the incidence of infections.
authors.affiliation: Department of Urology, Hospital Universitario 12 de Octubre, Madrid, Spain.
authors.forename: José
authors.initials: J
authors.lastname: Medina-Polo
authors.affiliation: Department of Urology, Hospital Universitario 12 de Octubre, Madrid, Spain.
authors.forename: Raquel
authors.initials: R
authors.lastname: Sopeña-Sutil
authors.affiliation: Department of Urology, Hospital Universitario 12 de Octubre, Madrid, Spain.
authors.forename: Raúl
authors.initials: R
authors.lastname: Benítez-Sala
authors.affiliation: Department of Urology, Hospital Universitario 12 de Octubre, Madrid, Spain.
authors.forename: Alba
authors.initials: A
authors.lastname: Lara-Isla
authors.affiliation: Department of Urology, Hospital Universitario 12 de Octubre, Madrid, Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: Alonso-Isa
authors.affiliation: Department of Urology, Hospital Universitario 12 de Octubre, Madrid, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Gil-Moradillo
authors.affiliation: Department of Urology, Hospital Universitario 12 de Octubre, Madrid, Spain.
authors.forename: Juan
authors.initials: J
authors.lastname: Justo-Quintas
authors.affiliation: Department of Urology, Hospital Universitario 12 de Octubre, Madrid, Spain.
authors.forename: Esther
authors.initials: E
authors.lastname: García-Rojo
authors.affiliation: Department of Urology, Hospital Universitario 12 de Octubre, Madrid, Spain.
authors.forename: Daniel Antonio
authors.initials: DA
authors.lastname: González-Padilla
authors.affiliation: Department of Urology, Hospital Universitario 12 de Octubre, Madrid, Spain.
authors.forename: Juan Bautista
authors.initials: JB
authors.lastname: Passas-Martínez
authors.affiliation: Department of Urology, Hospital Universitario 12 de Octubre, Madrid, Spain.
authors.forename: Ángel
authors.initials: Á
authors.lastname: Tejido-Sánchez
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000583:Amikacin / Q000494:pharmacology; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D015780:Carbapenems / Q000494:pharmacology; D002408:Catheters, Indwelling / Q000009:adverse effects; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology; D015653:Cystectomy / Q000009:adverse effects; D004352:Drug Resistance, Microbial; D016983:Enterococcus / Q000187:drug effects; D004926:Escherichia coli / Q000187:drug effects / Q000201:enzymology; D004927:Escherichia coli Infections / Q000453:epidemiology; D005260:Female; D024841:Fluoroquinolones / Q000494:pharmacology; D006757:Hospital Units / Q000706:statistics & numerical data*; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects; D015994:Incidence; D007709:Klebsiella / Q000187:drug effects; D007710:Klebsiella Infections / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011552:Pseudomonas Infections / Q000453:epidemiology; D011550:Pseudomonas aeruginosa / Q000187:drug effects; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000382:microbiology; D062885:Urinary Catheters / Q000009:adverse effects; D014552:Urinary Tract Infections / Q000453:epidemiology* / Q000382:microbiology; D014572:Urology / Q000706:statistics & numerical data*; D014640:Vancomycin / Q000494:pharmacology; D001618:beta-Lactamases / Q000378:metabolism
chemical_list: D000900:Anti-Bacterial Agents; D015780:Carbapenems; D024841:Fluoroquinolones; D014640:Vancomycin; D000583:Amikacin; D001618:beta-Lactamases
keywords: Hospital Urology Department; Infection control; Multiple drug resistance; Surgical wound infections; Urinary tract infections