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

Mete Cek, Zafer Tandoğdu, Florian Wagenlehner, P. Tenke, Kurt Naber, Truls Erik Bjerklund-Johansen

Research output: Contribution to journalArticle

36 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)1587-1594
Number of pages8
JournalWorld Journal of Urology
Volume32
Issue number6
DOIs
Publication statusPublished - Nov 19 2014

Fingerprint

Cross Infection
Urinary Tract Infections
Bacteriuria
Cephalosporins
Penicillins
Anti-Bacterial Agents
Cystitis
Fluoroquinolones
Urology
Aminoglycosides
Ciprofloxacin
Microbial Drug Resistance
Infection

Keywords

  • Antibiotics
  • Bacterial resistance
  • Healthcare-associated infection
  • Healthcare-associated urinary tract infection
  • Prevalence

ASJC Scopus subject areas

  • Urology
  • Medicine(all)

Cite this

Healthcare-associated urinary tract infections in hospitalized urological patients—a global perspective : results from the GPIU studies 2003–2010. / Cek, Mete; Tandoğdu, Zafer; Wagenlehner, Florian; Tenke, P.; Naber, Kurt; Bjerklund-Johansen, Truls Erik.

In: World Journal of Urology, Vol. 32, No. 6, 19.11.2014, p. 1587-1594.

Research output: Contribution to journalArticle

Cek, Mete ; Tandoğdu, Zafer ; Wagenlehner, Florian ; Tenke, P. ; Naber, Kurt ; Bjerklund-Johansen, Truls Erik. / Healthcare-associated urinary tract infections in hospitalized urological patients—a global perspective : results from the GPIU studies 2003–2010. In: World Journal of Urology. 2014 ; Vol. 32, No. 6. pp. 1587-1594.
@article{b76735bda0c94207aea7798c0492678b,
title = "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.",
keywords = "Antibiotics, Bacterial resistance, Healthcare-associated infection, Healthcare-associated urinary tract infection, Prevalence",
author = "Mete Cek and Zafer Tandoğdu and Florian Wagenlehner and P. Tenke and Kurt Naber and Bjerklund-Johansen, {Truls Erik}",
year = "2014",
month = "11",
day = "19",
doi = "10.1007/s00345-013-1218-9",
language = "English",
volume = "32",
pages = "1587--1594",
journal = "World Journal of Urology",
issn = "0724-4983",
publisher = "Springer Verlag",
number = "6",

}

TY - JOUR

T1 - Healthcare-associated urinary tract infections in hospitalized urological patients—a global perspective

T2 - results from the GPIU studies 2003–2010

AU - Cek, Mete

AU - Tandoğdu, Zafer

AU - Wagenlehner, Florian

AU - Tenke, P.

AU - Naber, Kurt

AU - Bjerklund-Johansen, Truls Erik

PY - 2014/11/19

Y1 - 2014/11/19

N2 - 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.

AB - 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.

KW - Antibiotics

KW - Bacterial resistance

KW - Healthcare-associated infection

KW - Healthcare-associated urinary tract infection

KW - Prevalence

UR - http://www.scopus.com/inward/record.url?scp=84912013494&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84912013494&partnerID=8YFLogxK

U2 - 10.1007/s00345-013-1218-9

DO - 10.1007/s00345-013-1218-9

M3 - Article

C2 - 24452449

AN - SCOPUS:84912013494

VL - 32

SP - 1587

EP - 1594

JO - World Journal of Urology

JF - World Journal of Urology

SN - 0724-4983

IS - 6

ER -