Antibiotic resistance pattern of the strains isolated in urinary tract infections in the last semester in the military hospital

Background

In the last years the antibiotic resistance is increasing, and self-medication is no longer the only reason. The study was designed to compare community urinary tract infections (UTI) and hospitalized patients’ UTI.

Method

We performed a retrospective study of the resistance pattern of the main strains isolated from the hospitalized patients admitted to the Emergency Military Hospital in Cluj-Napoca between 01 January – 30 June 2013, and from the urine sample of the ambulatory patients, during the same period. For antibiotic susceptibility we used the semiautomatic VITEK 2 system and the diffusimetric method. We studied demographic characteristics, in correlation with microbiological data.

Results

For the hospitalized patients: from 317 samples, 209 were positive, in which we isolated E coli=79%, Enterobacter=9.5%, Proteus spp=5%, Klebsiella=5%, Enterococcus spp, Serratia spp, Staphylococcus=1.5%. The E coli sensitivity to antimicrobial drugs was found to be as follows: ampicillin=30%, cefepime=50%, norfloxacin=62%, ofloxacin, ciprofloxacin=68%, biseptol=63%, amoxicillin+clavulanic acid=70%, ceftazidime=85%, amikacin=98%, nitrofurantoin and carbapenem=100%.

For the ambulatory patients: from 605 urinary samples, 318 were positive, in which we isolated: E coli=72.5%, Enterobacter=12.5%, Proteus=10%-mainly nosocomial, after prostatectomy or urinary catheter, Klebsiella, Enterococcus, Citrobacter=5%.

Conclusion

Urine culture is a routine microbiological investigation, even when not indicated. The treatment of asymptomatic bacteriuria is a controversial issue, especially for ambulatory patients. E coli remains the most common strain isolated in urine cultures, and the antimicrobial stewardship is necessary.