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

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.