Prospective study analyzing risk factors and characteristics of healthcare-associated infections in a Urology ward.
PURPOSE
Healthcare-associated infections (HAIs) in urological patients have special features due to specific risk factors. Our objective was to evaluate the characteristics and risk factors for HAIs in patients hospitalized in a Urology ward.


MATERIALS AND METHODS
We evaluated prospectively, from 2012 to 2015, the incidence, types and risk factor for HAIs, microbiological and resistance patterns.


RESULTS
The incidence of HAIs was 6.3%. The most common types were urinary infections (70.5%) and surgical site infections (22.1%). Univariate analysis showed an increased risk of HAIs among patients with American Society of Anesthesiologists physical status classification system III-IV (odds ratio [OR], 1.39; p<0.001), immunosuppression (OR, 1.80; p=0.013), previous urinary infection (OR, 4.46; p<0,001), and urinary catheter before admission (OR, 1.74; p<0.001). The surgical procedures with the highest incidence of HAIs were radical cystectomy (54.2%) and renal surgery (8.7%). The most frequently isolated microorganisms were Escherichia coli (25.1%), Enterococcus spp. (17.5%), Klebsiella spp. (13.5%) and Pseudomonas aeruginosa (12.3%). Enterococcus sp was the most common microorganism after radical cystectomy and in surgical site infections, E. coli showed resistance rates of 53.5% for fluoroquinolones, 9.3% for amikacin. The percentage of extended-spectrum betalactamase producing E. coli was 24.7%. Klebsiella spp. showed resistance rates of 47.8% for fluoroquinolones, 7.1% for amikacin and 4.3% for carbapenems. Enterococcus spp showed resistance rates of 1.7% for vancomycin and; P. aeruginosa of 33.3% for carbapenems and 26.2% for amikacin.


CONCLUSIONS
Comorbidities, previous urinary infections, and urinary catheter are risk factors for HAIs. The microorganisms most commonly isolated were E. coli, Enterococcus and P. aeruginosa. Prospective monitoring may decrease the incidence of infections.
['Medina-Polo|José|J|', 'Sopeña-Sutil|Raquel|R|', 'Benítez-Sala|Raúl|R|', 'Lara-Isla|Alba|A|', 'Alonso-Isa|Manuel|M|', 'Gil-Moradillo|Javier|J|', 'Justo-Quintas|Juan|J|', 'García-Rojo|Esther|E|', 'González-Padilla|Daniel Antonio|DA|', 'Passas-Martínez|Juan Bautista|JB|', 'Tejido-Sánchez|Ángel|Á|']
D000368:Aged D000369:Aged, 80 and over D000583:Amikacin D000900:Anti-Bacterial Agents D015780:Carbapenems D002408:Catheters, Indwelling D003428:Cross Infection D015653:Cystectomy D004352:Drug Resistance, Microbial D016983:Enterococcus D004926:Escherichia coli D004927:Escherichia coli Infections D005260:Female D024841:Fluoroquinolones D006757:Hospital Units D006801:Humans D007165:Immunosuppression Therapy D015994:Incidence D007709:Klebsiella D007710:Klebsiella Infections D008297:Male D008875:Middle Aged D011446:Prospective Studies D011552:Pseudomonas Infections D011550:Pseudomonas aeruginosa D012307:Risk Factors D013530:Surgical Wound Infection D062885:Urinary Catheters D014552:Urinary Tract Infections D014572:Urology D014640:Vancomycin D001618:beta-Lactamases
Hospital Urology Department Infection control Multiple drug resistance Surgical wound infections Urinary tract infections