Nosocomial urinary tract infections caused by Pseudomonas aeruginosa and Acinetobacter species: Sensitivity to antibiotics and risk factors

Background Pseudomonas aeruginosa and Acinetobacter species frequently cause intrahospital urinary tract infections (IUTI), contributing to increased hospital morbidity and mortality. Our objective was further exploration of possible risk factors for development of IUTI caused by P aeruginosa and Acinetobacter spp, including their resistance to various antibiotics. Methods The prospective case control study was conducted in Clinical Center Kragujevac, Serbia, during the period January 2009 to December 2011 and covered all patients with IUTI according to the Centers for Disease Control and Prevention criteria. The patients classified as “cases” had an IUTI caused by P aeruginosa or Acinetobacter spp. The control patients were matched to the cases and selected randomly from the remaining patients. Results There were 79 cases (11.9%) and 586 (88.1%) controls in the study. According to the multivariate binary logistic regression, there were 3 significant predictors of P aeruginosa and Acinetobacter spp IUTI: male sex (odds ratio [OR], 0.423; 95% confidence interval [CI]: 0.251-0.711; P  = .001), stay in another hospital ward before emergence of IUTI (OR, 1.704; 95% CI: 1.013-2.864; P  = .044), and previous use of penicillins and their combinations with inhibitors of β-lactamases (OR, 2.643; 95% CI: 1.044-6.692; P  = .040). Conclusion Knowing that IUTI caused by above-mentioned bacteria are especially frequent among male patients, after previous use of penicillins, and in patients who spent some time previously at other wards, sound strategies for prevention of such infections in clinical practice should be developed.