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Kim, Yim, Cho, Kim, Ha, Kim, Hong, Sohn, Lee, and Kim: Changes in Causative Organisms and Antibiotic Sensitivity in Intensive Care Unit-Acquired Urinary Tract Infection
Original Article
Infection/Inflammation
Korean Journal of Urology

Korean Journal of Urology 2009; 50(11): 1108-1113.

Published online: 19 November 2009

DOI: https://doi.org/10.4111/kju.2009.50.11.1108

Changes in Causative Organisms and Antibiotic Sensitivity in Intensive Care Unit-Acquired Urinary Tract Infection

Hee Youn Kim, Seung Hyuk Yim, Hyuk Jin Cho, Jae Sik Kim, U-Syn Ha, Doo Bae Kim, Sung Hoo Hong, Dong Wan Sohn, Ji Youl Lee, Sae Woong Kim

Department of Urology, The Catholic University of Korea College of Medicine, Seoul, Korea.

Correspondence to: Sae Woong Kim. Department of Urology, Seoul St. Mary's Hospital, 505, Banpo-dong, Seocho-gu, Seoul 137-701, Korea. TEL: 02-2258-1071, FAX: 02-2258-1080, ksw1227@catholic.ac.kr

Received 23 September 2009       Accepted 13 October 2009

Copyright © The Korean Urological Association, 2009

Abstract

Purpose

Patients in the intensive care unit (ICU) are usually at greater risk for acquiring urinary tract infection (UTI). Few studies have focused on UTI specifically acquired within the ICU. We retrospectively studied and compared the microbiology and antibiotic sensitivity of UTI in ICU-admitted patients between 2001 and 2008.

Materials and Methods

We reviewed the medical records of a total of 1,818 ICU patients who had undergone a urine culture exam in 2001 and 2008 in a single hospital. Changes in causative organisms and their antibiotic sensitivity between 2001 and 2008 were analyzed.

Results

The common pathogens in 2008 were Escherichia coli (20.3%), Pseudomonas (19.5%), Enterococcus (18.0%), Klebsiella (7.8%), coagulase-negative Staphylococcus (CNS) (4.3%), and Staphylococcus (4.3%). Pseudomonas species significantly increased in 2008 compared with 2001 (p=0.002). Gram-negative organisms showed relatively higher sensitivities to amikacin, imipenem, and Tazocin (72.1%, 76.2%, and 74.6%, respectively), whereas they showed relatively lower sensitivities to third-generation cephalosporins and ciprofloxacin (43% to 59%). Gram-positive organisms showed high sensitivities to teicoplanin and vancomycin (91.2% and 86.8%, respectively), whereas they showed low sensitivities to ampicillin and ciprofloxacin (25% and 26.5%, respectively). The antibiotic resistance of Pseudomonas species was nearly double that of E. coli.

Conclusions

E. coli, Pseudomonas, and Enterococcus were the three most common organisms in ICU-acquired UTI in our study. In particular, Pseudomonas species were found to have increased significantly in recent years. Pseudomonas species had a significantly lower susceptibility to antibiotic sensitivity than did the other organisms.

Keywords: Urinary tract infections, Intensive care units

Figures and Tables

Table 1
Species distribution of the isolates from patients with urinary tract infections in 2001 versus 2008
kju-50-1108-i001
Table 2
Changes in drug sensitivities for gram-stained pathogens in 2001 versus 2008
kju-50-1108-i002

AC: ampicillin, CL: cephalothin, CZ: ceftazidime, CT: cefotaxime, GM: gentamicin, AK: amikacin, TM: tobramycin, CF: ciprofloxacin, LF: levofloxacin, IP: imipenem, BT: bactrim, TZ: tazocin, EM: erythromycin, TC: tetracycline, TP: teicoplanin, VM: vancomycin

Table 3
Antibiotic sensitivities of the gram-negative organisms
kju-50-1108-i003

AC: ampicillin, CL: cephalothin, CZ: ceftazidime, CT: cefotaxime, GM: gentamicin, AK: amikacin, TM: tobramycin, CF: ciprofloxacin, LF: levofloxacin, IP: imipenem, BT: bactrim, TZ: tazocin

Table 4
Antibiotic sensitivities of the gram-positive organisms
kju-50-1108-i004

GM: gentamicin, TC: tetracycline, AC: ampicillin, CL: cephalothin, TP: teicoplanin, VM: vancomycin, CF: ciprofloxacin, CNS: coagulase-negative Staphylococcus

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