Evaluation of bacteriuria and antimicrobial susceptibility among hospitalized patients with and without catheter in Kerman province- Iran in 2011

F Sarrafzadeh1, SM Sohrevardi2, M Yazdizadeh1. 1Kerman University of Medical Sciences, Department of Internal Medicine - Post code 7616914111, Iran, 2Shahid Sadoughi University of Medical Sciences, Faculty of Pharmacy, Department of Clinical Pharmacy - Postcode 8915173143, Iran

Introduction: Nearly 15% to 25% of patients in general hospitals have a catheter at some time during their stay. Nosocomial Urinary tract infections (UTIs) up to 97% is related to catheter. Type of bacteremia is usually polymicrobial which making treatment more difficult. Studies showed that in these patients, mortality of bacteremia is probable. In order to compare prevalence of UTIs among patients with and without catheter and detecting type of bacteriuria and antibacterial resistance pattern, this study was done.

Method and material: In this cross sectional study, samples were taken between Jan 2011 to July 2011. 678 hospitalized patients in different wards of Afzali-Pour hospital, Kerman- Iran, were enrolled the study. In patients without catheter, midstream method were used for sampling. In patients who had urine catheter, samples were taken after catheter clamping. Samples were immediately transported to the laboratory and cultured on the blood agar environment (for differentiate types of enterobacterias family). After 24 h incubation at 37°C, colonies were counted. Samples with colony count more than 10 5 were considered as positive. E_test strip was used to detect pattern of resistance to gentamicin, nitrofurantoin, ciprofloxacin, ceftriaxon and co-trimoxazole. SPSS16 has been used For statistical analysis. Fishers exact test was used to determine statistical differences among patients.

Result: Among positive culture samples 86% were women. Escherichia coli in 72%, candida albicance in 10% and staphylococcus were detected in 7% of positive cultures. 56% of detected E.coli was sensitive to gentamicin , 60% to ceftriaxine, 74% to ciprofloxacin and finally 59% was sensitive to nitrofurantoin.

Discussion: As regards in this research the most sensitive antibiotics in UTIs were ciprofloxacin and ceftriaxone. Unfortunately rate of antibacterial resistance was high in comparison with developed countries. Wise selection of antibiotics at hospitals can reduce antimicrobial resistance.

Keywords: Nosocomial, Infection, UTIs, Urinary catheter, E.coli, Antibiotic