Evaluation of Patients Followed with Complicated Urinary Tract Infection: A Single Centre Experience

Authors : Bahar Busra Özkan, Özgür Günal, Mehmet Derya Demirag, Selda Sözen, Süleyman Sırrı Kilic

Pages : 34-44

Doi:10.58854/jicm.1428784

View : 107 | Download : 169

Publication Date : 2024-06-30

Article Type : Research

Abstract :Aim: Urinary tract infection (UTI) is one of the most common infectious diseases and broad-spectrum antibiotics are commonly used for its treatment. Increased use of these antibiotics is leading to a rapid increase in antibiotic resistance rates in the treatment of UTIs. In this study, we aimed to determine the causative agents and antibiotic resistance profile of these agents in patients with complicated urinary tract infections treated as inpatients in our clinic. Methods: In the present study, we retrospectively evaluated the inpatients with complicated urinary tract infections in our clinic within a one-year period. Results: The study included 154 patients (69 (44.8%) were male, 85 (55.2%) were female) with a mean age of 68.9 ± 15.3 years. The most common comorbidities were essential hypertension (n:87, 56.5%), type 2 diabetes mellitus (n:74, 48.1%), and cerebrovascular disease/coronary artery disease (n:49, 31.8%). The most common UTI agents were E.coli (46.1%), Klebsiella spp (14.9%), and Candida spp (7.1%). While 42.6% of these E.coli produced extended spectrum beta-lactamase (ESBL), 13% of Klebsiella spp produced ESBL. The frequency of ciprofloxacin resistance was statistically significantly higher in ESBL-positive bacteria compared to ESBL-negative bacteria (84.8%/35.9%, p<0.001). Resistance rates to trimethoprim/sulfamethoxazole (56.7% / 36.2%), amikacin(37% / 19%), and fosfomycin (13.3% / 28.1%), which may be alternative treatment options, were found to be at high levels, yet they were similar in ESBL-positive and negative bacteria. Conclusion: Increasing rates of antibiotic resistance make the treatment of infections more difficult and costly. Therefore, appropriate antibiotics should be administered at the optimum dose and duration based on local and national surveillance data for the treatment of UTIs.
Keywords : İdrar yolu enfeksiyonları, Antibakteriyel ilaç direnci, İlaç direnci