Microorganisms grown in urine cultures and antimicrobial resistance patterns: A randomised retrospective analysis from a tertiary hospital

Abstract

Introduction: Patients in intensive care units (ICU) are 5-7 times more susceptible to infection than other groups, which increases the prevalence of hospital-acquired infections and associated sepsis accounting for 60% of deaths. Gram-negative bacteria are the most common source of urinary tract infections that cause morbidity, mortality, and sepsis in the ICU. The aim of this study is to detect the most commonly grown microorganisms and antibiotic resistance in urine cultures in the intensive care units of our tertiary city hospital, which has more than 20% of the ICU beds in Bursa By this way, we suppose that we will contribute to surveillance studies in our province, our country.

Methodology: Patients who were admitted to Bursa City Hospital adult ICU for various reasons between 15.07.2019 and 31.01.2021 and had growth in urine cultures were retrospectively screened. The urine culture result, growing microorganism, antibiotic used, and resistance status were recorded and analyzes were performed according to hospital data.

Results: Gram-negative growth was observed in 85.6% (n = 7707), gram-positive growth in 11.6% (n = 1045), and candida fungus growth in 2.8% (n = 249). Resistance to at least one antibiotic in urine cultures was observed for Acinetobacter (71.8), Klebsiella (51%), Proteus (47.95%), Pseudomonas (33%), E. coli (31%) and Enterococci (26.75%), respectively.

Discussion: Developing a health system leads to longer life expectancy, longer intensive care treatment, and more frequent interventional procedures. In terms of being a resource for empirical treatments, early initiation of empirical treatments to control the urinary tract infection disrupts the patient's hemodynamics and increases mortality and morbidity.