Incidence, Causative Organisms and Pattern of Drug Resistance of Nosocomial Urinary Tract Infection in Patients with Liver Cirrhosis

Document Type : New and original researches in the field of Microbiology.

Author

Lecturer at Department of Medical Microbiology & Immunolgy, Assiut University, Assiut, Egypt

Abstract

Background: The nosocomial urinary tract infections (UTIs) creates a major health problem in hospitals all over the world. Objectives: We aimed in this study to determine the incidence of nosocomial UTIs in our cirrhotic patients, identification of the most common pathogens responsible for nosocomial UTIs and identification of the pattern of drug resistance. Methodology: 366 cirrhotic patients were studied within one year. Patients with apparent clinical manifestations of any UTI at time of admission were excluded. All patients were subjected to clinical evaluation, abdominal ultrasound examination, and laboratory investigations including complete blood picture, renal function tests, liver function tests and urine analysis at time of admission. Urine samples were collected from the infected patients for both bacterial and fungal cultures and drug sensitivity testing. Results: The frequency of nosocomial UTIs in cirrhotic patients was 7.1%.  The most significant risk factor was urinary catheterization (OR=189.0). Gram negative bacilli were the first cause (46%) of nosocomial urinary tract infection followed by fungi (36%). The sensitivity revealed that the most sensitive antibiotic for both Gram positive and Gram negative cocci was Gatifloxacin. The most sensitive antifungal for candida albicans was Nystatin. Conclusion: The frequency of nosocomial UTIs in cirrhotic patients was not low. Malnutrition and urinary catheterization were the most significant risk factors. Urinary fungal infection was not rare and must be in mind. Both bacterial and fungal cultures and their sensitivity to antibacterial and antifungal drugs were very important to improve the survival rate of patients.

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