Asymptomatic bacteriuria (ABU) refers to the presence of germs in the urinary tract without clinical symptoms and occurs frequently in hospitalized patients. Although antibiotic therapy is useless, many patients with ABU receive antimicrobials, which can lead to the selection of bacterial strains resistant to multiple antibiotics.
BACKGROUNDThe aim of our study was to asses the asymptomatic bacteriuria prevalence in patients from a Clinical Emergency County Hospital.
PURPOSE & AIMS
Adult patients admitted to hospital with ABU within 24 hours between March to August 2015 were reviewed.These infections are usually caused by E. coli, Proteus, Pseudomonas, Klebsiella and Serratia. Many of the infecting strains show markedly increased resistance to antimicrobials, compared with organisms that cause urinary tract infections acquired in the community. Exclusion criteria included: patients < 18 years and elderly > 85 years, pregnant women, patients undergoing invasive urological and surgical procedures and immunocompromised patients. Descriptive statistics were used for baseline demographics, continuous and discrete variables.
MATERIAL AND METHODS
A total of seventy six patients were evaluated. Mean age was 71.4 (±8.2) years and 59 (77,63%) were female. Of these, 54 patients (71,05%) were presented at Medical Department of the Emergency Room of the hospital, 3 (3,94%) patients already had a bladder catheter at the time of admission. 26 (34,21%) ABU patients were without symptoms of a urinary tract infection (only positive urine culture). Of these, 14 patients (53,84%) received antimicrobials. 5 of 14 (35,71%) patients had signi�cant bacteriuria (presence of over 100,000 colony forming units (CFU) / mL urine) and received antimicrobial therapy. 34 patients (44,73%) had contamination of the sample urine (in which case the sample was collected again).In 9+24 = 33 patients without bacteriuria were treated with antibiotics, but the treatment was justi�ed only in 24 patients (72.72%) due to the presence of symptomatic UTIs.
RESULTS
O.L. Filip1, C.D. Calina1, C. Bocsaru1, A. Docea1, P. Mitrut2, M.V. Bubulica1, M. Balasoiu2, O. Zlatian1, L. Rosu1, A.F. Rosu1
1University of Medicine and Pharmacy, Faculty of Pharmacy, Craiova, Romania.2University of Medicine and Pharmacy, Faculty of Medicine, Craiova, Romania.
ASYMPTOMATIC BACTERIURIA ASSESSMENT IN PATIENTS ADMITTED TO A CLINICAL EMERGENCY HOSPITAL
University of Medicine and Pharmacy
CRAIOVA, ROMANIA
E-mail :[email protected]
CP-185
More than half (53,84%) of ABU patients received inappropriately antibiotics. Active collaboration between physicians and clinical hospital pharmacist and correct urine collection technique for laboratory
analysis are solutions for avoiding an inappropriate treatment of ABU. The results of our study highlight the importance of reducing antibiotic therapy in ABU.
CONCLUSIONS
76 patients
Without UTI symptoms
26 (34.21%)
Treated with antibiotics
14 (53.84%)
Significant bacteriuria5 (35.71%)
Bacteriuria under 10^5 CFU/ml
9 (64.29%)Untreated with antibiotics
12 (46.13%)
With UTI symptoms
50
Treated with antibiotics50 (100%)
Significant bacteriuria 26 (52.00%)
Bacteriuria under 10^5 CFU/ml24 (48.00%)
Presence of UTIs symptoms, bacteriuria and antibiotic treatment in patient lot
PARAMETER LEVELS No. Percent (%)
Sex Males 17 22.37 Females 59 77.63
Age
<= 60 years 8 10.53 61-70 years 28 36.84 71-80 years 32 42.11 >80 years 9 11.84
Highest level of education
Primary school 6 7.89 Highschool graduate 35 46.05 College graduate 25 32.89 Graduate or professional degree 10 13.16
Marital status
Married or living as married 41 53.95 Divorced 10 13.16 Widowed 20 26.32 Never married 5 6.58
Sexual history Sexual intercourse in the past year 25 32.89
Frequency of intercourse per month
Never 51 67.11 1-5 23 30.26 >=6 2 2.63
History of UTIs (No. of UTIs in the lifetime)
0 24 31.58 1-5 34 44.74 6-10 11 14.47 >10 7 9.21
UTI during follow-up No UTI during follow-up 63 82.89 Symptomatic UTI 8 10.53 Asymptomatic UTI 5 6.58
Characteristics of patient group
Contamination of urine samples
Number of previous UTIs
Patient sex distribution
Presentation of the patients
