Nosocomial urinary tract infections in Baghdad Teaching Hospital

الملخص EN

Objectives : The objectives of the present study are to identify both, the rate of urinary tract infections (UTI) in medical and surgical wards in Baghdad Teaching Hospital and the common types of microorganisms that cause this type of NIs, study the resistance of isolated microorganisms to several types of antibiotic and the effect of some disinfection material like Iodine, chlorhexidine and septic in on the growth of these isolates.

Methodology : This is descriptive study carried out from 1\6\2009 to 1\11\2009.

A total of 200 patients were admitted to medical and surgical wards in Baghdad teaching hospital, patients were divided into two group 100 patients, in surgical ward and 100 patients in medical ward.

Some of important information was recorded.

Urine samples were cultured on different culture media in order to isolate different pathogenic bacteria.

Then, the sensitivity of these isolates were tested against different antimicrobials, antibiotics (amikacin, Ampicillin, cefixime, Cefotaxime, Cephalexin, Gentamicin, Nalidixic acid, nitrofuranion, rifimpicin and Vancomycin) and the effects of different disinfectant solutions with different concentrations ; including benzalkonium chloride (septic in, commercial), chlorhexidine and povidoniodine (betadine, commercial), were tested as well on the growth of isolated bacteria.

Results : The results show that a high incidence of (UTI) as nosocomial infections appeared in medical and surgical wards in Baghdad Teaching Hospital and most of patients were male at age groups ranged from 46-55 years and 36-45 years in medical and surgical ward respectively.

The highest rate of UTIs increased in patients who had needed catheterization procedures in both wards.

Gram negative bacteria were commonly p.

aeruginosa and E.

coli, less commonly gram positive bacteria like methicillin-resistant Staph aureus were isolated as etiologic agents of UTIs infections in both wards.

Moreover, multi-drug resistance for common use antibiotics was observed in most virulent species like Pseudomonas aeruginosa and Methicillin resistant Staphylococcus aureus (MRSA).

Nitrofuranion was the best drug for all bacterial isolates.

It was obvious that 10-15 % of provision-iodine solution has more effect on the growth controlling of pathogenic bacteria, especially Pseudomonas aeruginosa isolates.

The results indicated significant differences (p˂0.01) between the effect of Septic in and Chlorhexidine on the activity of isolated bacteria.

Recommendations : The study recommends that the catheter should be changed every 2 days, especially if signs of urinary tract infections appear and using antimicrobial catheters and intelligent use of aseptic techniques, and limiting the use of antibiotics and the use of most effective disinfectant in the exact concentration specified by the manufacture, and the detection antibiotic resistance gene using Polymerase Chain Reaction (PCR) technique.