Characterization of the health-care-associated urinary tract infections at the Hospital das Clínicas de Ribeirão Preto, São Paulo, Brazil

Abstract

Urinary tract infections (UTIs) are the most common health-care-associated infections (HCAIs) and one of the top-ranking microbial infections. In the community, about 80% of UTIs are caused by uropathogenic Escherichia coli (UPEC), but there is a high variability of etiological agents involved in hospital-acquired UTIs. With this context in mind, the current study aimed to evaluate the prevalence of the main etiological agents responsible for UTIs and their susceptibility profile at the Hospital das Clínicas de Ribeirão Preto, a high complexity reference hospital in the Southeast region of Brazil. This retrospective and descriptive study analyzed all positive inpatient cultures [100,000 colony-forming unit (CFU)/mL] from November 2016 to April 2017. The most prevalent microorganism was Klebsiella pneumoniae (23 isolates), equivalent to 37.7% of positive urocultures. The second most prevalent agent was UPEC, with 19 isolates (31.1%). The risk factors evaluated in these inpatients showed that 17.5% underwent a urological procedure on admission, 31.6% were using a urinary catheter; 26.2% were using immunosuppressive drugs during the period in which the clinical diagnosis was made. Our results demonstrate the prevalence of UTI causes in the hospital context and the main risk factors for them and will be pretty helpful in guiding empirical treatment in severe UTIs inside the hospital as well as reflect on the actual need and time duration of invasive procedures in the hospital environment.