Acta Medica Medianae
Urološka klinika Kliničkog centra
Bulevar dr Zorana Đinđića
18000 Niš, Srbija
Copyright 2007 by Faculty of Medicine, University of Nis
CORRELATION BETWEEN BACTERIOLOGICAL, LABORATORY AND CLINICAL CHARACTERISTICS OF NOSOCOMIALLY ACQUIRED URINARY TRACT INFECTIONS (NAUTI)
Urology Clinic Clinical Center of Niš
Urinary tract infections occurring at least 48 hours upon acceptance in hospital can be considered as nosocomially acquired. Microorganisms, which cause them, are various and show a high degree in antibiotic resistance. Clinical characteristics of NAUTI can vary from slightly elevated values of C-reactive protein (CRP) to sepsis with lethal results. The aim of the paper was to evaluate bacteriological, laboratory and clinical parameters of NAUTI as well as their correlation.
The study included seventy-five patients of Urology Clinic during the period of four months. Three samples of urine were taken to determine NAUTI and multiple antibiotic resistance index (MAR). The samples were taken on the admitance day, on the fifth day in hospital and on the fifth postoperative day. Blood samples were taken at the same time to determine laboratory characteristics. Clinical parameters were also noted. Bacteriological, laboratory and clinical characteristics were analyzed using Pearson’s correlation test.
The most frequently isolated microorganism was E. Coli (28%). In 48 urine samples (62%), the number of isolated bacteria was under 105 /ml of urine. MAR index showed in 61 isolates (74, 4%) values higher than 0,5. Forty-two patients (56%) had fever. Shiver was registered in 22 (29, 3%) patients. Nine patients (12%) had sepsis. CRP values were elevated in 66 (88%) patients, while values of serum leukocytes were over 10x109/l in 21 (28%).
The most common pathogens of NAUTI were E. Coli, Klebsiella and Pseudomonas. There was a high level of antibiotic resistance among pathogens causing NAUTI. CRP was the most sensitive routine parameter for NAUTI. The rise in number of isolated bacteria in patients with NAUTI was followed by the elevation of CRP. Leukocytosis was not a parameter sensitive enough for determining and following NAUTI. NAUTI’s were followed in more than half of cases by fever, while shiver was not very common. The incidence of sepsis in NAUTI was 12 percent. Acta Medica Medianae 2007;46(2):5-8.
Key words: correlation, nosocomial infection, laboratory parameters, clinical parameters