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Bacterial flora of lower urinary tract in men with indwelling catheters in years 1994-1996 and 2004-2006
Article published in Urologia Polska 2008/61/3.

authors

Łukasz Zapała, Bartosz Dybowski, Ewa Bres-Niewada, Anna Sonczyk, Anna Adamska, Andrzej Borkowski
Katedra i Klinika Urologii Warszawskiego Uniwersytetu Medycznego

keywords

benign prostatic hyperplasia (BPH) indwelling urinary catheter antibiotic resistance

summary

Introduction.

Persistent indwelling catheters frequently are the source of infections with multidrug resistant strains and perioperative complications.

The aim of the study.

The aim of the study was to compare the bacterial species and the antibiotic resistance of strains isolated from urine of catheterized patients with benign prostatic hyperplasia (BPH) hospitalized in years 1994-1996 and 2004-2006.

Material and methods.

Clinical records and urine cultures performed at admission of patients with BPH and indwelling catheters were analyzed. All the patients hospitalized in our department in years 1994-1996 and 2004-2006 were enrolled.

Results.

In years 1994-1996 156 BPH patients with indwelling catheters were hospitalized, and in years 2004-2006 there were 117 patients. Median of catheterization time was 2 and 3 months respectively. Bacteriuria was found in 76.3% and in 83.8% individuals respectively. In the reported period the rate of Gram-positive strains increased from 10% to 25%. Resistance of Gram-negative strains
increased to amoxicilin+clavulanic acid, cefuroxime, amikacin and ciprofloxacin. However, significant decrease of resistance to cotrimoxazol was found. Among Gram-positive strains resistance increased to amoxicilin+clavulanic acid, ciprofloxacin, nitrofurantoin and tetracyclines. In years 2004-2006 98% of Gram-negative strains were susceptible to imipenem and all Gram-positive bacteria were susceptible to vancomycin.

Conclusions.

Changes in resistance of catheter-associated flora make indispensable use of combined antimicrobial therapy. It is crucial to improve catheter management and to use antibiotics in permanently catheterized patients responsibly. Rigorous hygienic measures should be implemented in rooms where catheters are replaced. The patients with permanent catheters should be isolated on wards.

references

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correspondence

Łukasz Zapała
Klinika Urologii
ul. Lindleya 4
02-005 Warszawa
tel. (022) 502 17 23
rodmin@go2.pl