Healthcare-associated urinary tract infections in hospitalized urological patients--a global perspective: results from the GPIU studies 2003-2010

Abstract

Introduction: European Section for Infections in Urology has been conducting an annual prevalence survey investigating various aspects of healthcare-associated urinary tract infections (HAUTI) since 2003.

Material and methods: The data on various clinical categories of HAUTI, the contamination status of HAUTI patients who underwent any urological intervention with regard to microorganisms isolated, resistance status and antibiotics used to treat HAUTI will be presented.

Results: Of a total of 19,756 patients screened, 1,866 patients had HAUTI (9.4 %); 1,313 males (70.4 %) and 553 (29.6 %) females. Mean age was 59.9 ± 18.2. Asymptomatic bacteriuria (ASB) and cystitis were the most frequent clinical diagnoses representing 27.0 and 26 % of all HAUTI, respectively. Echerichia coli was found to be the most frequent uropathogen (544 of 1,371 isolates) (39.7 %). Fluoroquinolones were preferred in 26.6 % of cases followed by cephalosporins (23.3 %), aminoglycosides (14.1 %) and penicillins (13.8 %). High global resistance rates to ciprofloxacin (>50 %), cephalosporins (35-50 %) and penicillins (50 %) were found in the GPIU studies 2003-2010.

Discussion: We showed that around 10 % of hospitalized urological patients are at risk to develop HAUTI often caused by multiresistant uropathogens. Increased antibiotic use often with broad-spectrum antimicrobials will inevitably be followed by increasing bacterial resistance. To interrupt such a vicious cycle, our results suggest (1) there is still room for improvement in surgical prophylaxis in terms of limiting exposure to antibiotics and (2) far too many patients with ASB are being treated which shows that the new proposal of classification should be adopted where ABS is regarded as colonization and not as an infection to be treated.