Table I
Characteristic of patients with UTI enrolled in the study.
| Characteristic | Total UTI n = 498 (100%) | CAUTI n = 60 (100%) | non-CAUTI n = 438 (100%) | OR (95% CI) | p-value | ||||
|---|---|---|---|---|---|---|---|---|---|
| n | % | n | % | n | % | ||||
| Gender: | Male | 179 | 35.9% | 37 | 61.7% | 142 | 32.4% | 3.35 (1.92–5.86) | < 0.001 |
| Female | 319 | 64.1% | 23 | 38.3% | 296 | 67.6% | 0.30 (0.17–0.52) | < 0.001 | |
| Hypertension | 263 | 52.8% | 37 | 61.7% | 226 | 51.6% | 1.51 (0.87–2.62) | 0.145 | |
| Heart failure | 174 | 34.9% | 23 | 38.3% | 141 | 32.2% | 1.31 (0.75–2.29) | 0.344 | |
| Diabetes mellitus | 190 | 38.2% | 18 | 30.0% | 172 | 39.3% | 0.72 (0.40–1.28) | 0.258 | |
| Urolithiasis | 22 | 4.4% | 1 | 1.7% | 21 | 4.8% | 0.34 (0.04–2.55) | 0.292 | |
| Bronchopneumonia | 9 | 1.8% | 1 | 1.7% | 8 | 1.8% | 0.91 (0.11–7.41) | 0.931 | |
| Malignancy (total) | 80 | 16.1% | 11 | 18.3% | 69 | 15.8% | 1.34 (0.68–2.65) | 0.405 | |
| Genitourinary malignancy | 41 | 8.2% | 9 | 15.0% | 32 | 7.3% | 2.24 (1.01–4.96) | 0.047 | |
| Prostatic hyperplasia | 57 | 11.4% | 10 | 16.7% | 47 | 10.7% | 1.66 (0.79–3.50) | 0.180 | |
| Urine stasis in kidneys | 23 | 4.6% | 5 | 8.3% | 18 | 4.1% | 4.34 (1.76–10.73) | 0.001 | |
| Percutaneous nephrostomy | 8 | 1.6% | 1 | 1.7% | 7 | 1.6 % | 1.04 (0.13–8.63) | 0.968 | |
| Hemodialysis | 20 | 4.0% | 2 | 3.3% | 18 | 4.1% | 0.80 (0.18–3.56) | 0.774 | |
| Immunotherapy | 26 | 5.2% | 4 | 6.7% | 22 | 5.0% | 1.35 (0.45–4.06) | 0.593 | |
Table II
Microbial uropathogens isolated from the urine samples.
| Pathogen | Total UTI | CAUTI | non-CAUTI | OR (95% CI) | p-value | |||
|---|---|---|---|---|---|---|---|---|
| n | % | n | % | n | % | |||
| E. coli | 363 | 72.9% | 37 | 61.7% | 326 | 74.4% | 0.55 (0.31–0.97) | 0.039 |
| Proteus sp. | 30 | 6.0% | 6 | 10.0% | 24 | 5.5% | 1.92 (0.75–4.90) | 0.174 |
| Staphylococcus sp. | 12 | 2.4% | 5 | 8.3% | 7 | 1.6% | 5.60 (1.72–18.24) | 0.004 |
| Enterobacter sp. | 20 | 4.0% | 4 | 6.7% | 16 | 3.7% | 1.88 (0.61–5.84) | 0.272 |
| Klebsiella sp. | 40 | 8.0% | 2 | 3.3% | 38 | 8.7% | 0.36 (0.09–1.54) | 0.170 |
| Enterococcus sp. | 11 | 2.2% | 2 | 3.3% | 9 | 2.0% | 1.64 (0.35–7.80) | 0.532 |
| Other | 22 | 4.4% | 4 | 6.7% | 18 | 4.1% | 1.67 (0.54–5.10) | 0.371 |
| Total | 498 | 100.0% | 60 | 100.0% | 438 | 100.0% | – | – |
2 Pseudonomas sp. (n = 6), Morganella morganii (n = 4), Acinetobacter baumanii (n = 3), Serratia sp. (n = 3), Citrobacter sp. (n = 2), Raoultella planticola (n = 1), Salmonella (n = 1), Stenotrophomonas maltophilia (n = 1), Streptococcus agalactiae (n = 1) ESBL-producing pathogens responsible for CAUTI: E. coli (n = 6), Klebsiella sp. (n = 2), Enterobacter sp. (n = 1) ESBL-producing pathogens responsible for non-CAUTI: E. coli (n = 23), Klebsiella sp. (n = 12), Enterobacter sp. (n = 11), Proteus sp. (n = 4)
Table III
Susceptibility profile of E. coli isolates studied to various antimicrobial agents.
| Antibiotics | Total UTI (n = 363) | CAUTI (n = 37) | non-CAUTI (n = 326) | OR (95% CI) | p-value | |||
|---|---|---|---|---|---|---|---|---|
| n’ | % susc. | n’ | % susc. | n’ | % susc. | |||
| Beta-lactam antibacterials, penicylinns | ||||||||
| Ampicillin | 354 | 30.2% | 36 | 19.4% | 318 | 31.4% | 0.53 (0.22–1.24) | 0.143 |
| AM/CL | 361 | 49.9% | 37 | 43.2% | 324 | 50.6% | 0.74 (0.37–1.48) | 0.397 |
| PIP/TZ | 207 | 87.0% | 19 | 68.4% | 188 | 88.8% | 0.27 (0.09–0.79) | 0.017 |
| Aminoglycosides | ||||||||
| Amikacin | 211 | 88.2% | 18 | 61.1% | 193 | 90.7% | 0.16 (0.06–0.47) | 0.001 |
| Gentamicin | 211 | 91.0% | 20 | 70.0% | 191 | 93.2% | 0.17 (0.06–0.52) | 0.002 |
| Cephalosporins | ||||||||
| Cefalexin | 197 | 79.7% | 17 | 41.2% | 180 | 83.3% | 0.14 (0.05–0.40) | < 0.001 |
| Cefuroxime | 358 | 85.8% | 36 | 75.0% | 322 | 87.0% | 0.45 (0.20–1.02) | 0.057 |
| Cefotaxime | 238 | 87.0% | 22 | 63.6% | 216 | 89.4% | 0.21 (0.08–0.55) | 0.002 |
| Ceftazidime | 237 | 83.5% | 21 | 61.9% | 216 | 85.6% | 0.27 (0.10–0.71) | 0.008 |
| Cefepime | 210 | 89.5% | 19 | 73.7% | 191 | 91.1% | 0.27 (0.09–0.85) | 0.025 |
| Antipseudomonal fluoroquinolones | ||||||||
| Ciprofloxacin | 361 | 70.4% | 37 | 54.1% | 324 | 72.2% | 0.45 (0.23–0.90) | 0.024 |
| Norfloxacin | 360 | 60.3% | 37 | 40.5% | 323 | 62.5% | 0.41 (0.20–0.82) | 0.011 |
| Folate pathway inhibitors | ||||||||
| Cotrimoxazole | 358 | 72.3% | 36 | 72.2% | 322 | 72.4% | 0.99 (0.46–2.14) | 0.986 |
| Antipseudomonal carbapenems | ||||||||
| Imipenem | 179 | 100.0% | 18 | 100.0% | 161 | 100.0% | – | – |
| Nitrofuran derivatives | ||||||||
| Nitrofurantoin | 357 | 89.4% | 37 | 83.8% | 320 | 90.0% | 0.57 (0.22–1.48) | 0.251 |
Table IV
Susceptibility profile of E. coli (n = 363) isolated from patients of different age groups.
| Antibiotics | 19–74 years (n = 133) | 75–85 years (n = 134) | > 85 years (n = 96) | 75–85 years vs. 19–74 years | > 85 years vs. 19–74 years | |||||
|---|---|---|---|---|---|---|---|---|---|---|
| n’ | % susc. | n’ | % susc. | n’ | % susc. | OR (95% CI) | p-value | OR (95% CI) | p-value | |
| Ampicillin | 132 | 31.1% | 130 | 26.9% | 92 | 33.7% | 0.82 (0.48–1.40) | 0.461 | 1.13 (0.64–1.99) | 0.678 |
| AM/CL | 133 | 49.6% | 133 | 51.1% | 95 | 48.4% | 1.06 (0.66–1.72) | 0.806 | 0.95 (0.56–1.61) | 0.858 |
| PIP/TZ | 73 | 86.3% | 80 | 85.0% | 54 | 90.7% | 0.90 (0.36–2.23) | 0.819 | 1.56 (0.50–4.85) | 0.446 |
| Amikacin | 74 | 90.5% | 83 | 81.9% | 54 | 94.4% | 0.47 (0.18–1.24) | 0.127 | 1.78 (0.44–7.21) | 0.422 |
| Gentamicin | 72 | 88.9% | 85 | 89.4% | 54 | 96.3% | 1.06 (0.38–2.89) | 0.916 | 3.25 (0.66–15.97) | 0.147 |
| Cefalexin | 70 | 74.3% | 78 | 75.6% | 49 | 93.9% | 1.07 (0.51–2.26) | 0.849 | 5.31 (1.47–19.19) | 0.011 |
| Cefuroxime | 132 | 85.6% | 133 | 82.0% | 93 | 91.4% | 0.76 (0.40–1.47) | 0.421 | 1.79 (0.75–4.28) | 0.193 |
| Cefotaxime | 83 | 81.9% | 95 | 85.3% | 60 | 96.7% | 1.28 (0.58–2.83) | 0.548 | 6.40 (1.40–29.14) | 0.017 |
| Ceftazidime | 83 | 80.7% | 94 | 81.9% | 60 | 90.0% | 1.08 (0.51–2.31) | 0.839 | 2.15 (0.79–5.87) | 0.136 |
| Cefepime | 73 | 84.9% | 82 | 87.8% | 55 | 98.2% | 1.28 (0.51–3.21) | 0.602 | 9.58 (1.20–76.64) | 0.033 |
| Ciprofloxacin | 132 | 72.0% | 134 | 67.9% | 95 | 71.6% | 0.82 (0.49–1.39) | 0.471 | 0.98 (0.55–1.76) | 0.949 |
| Norfloxacin | 133 | 62.4% | 132 | 59.1% | 95 | 58.9% | 0.87 (0.53–1.43) | 0.581 | 0.86 (0.50–1.48) | 0.598 |
| Cotrimoxazole | 130 | 74.6% | 133 | 67.7% | 95 | 75.8% | 0.71 (0.42–1.22) | 0.215 | 1.06 (0.58–1.97) | 0.841 |
| Imipenem | 57 | 100.0% | 74 | 100.0% | 48 | 100.0% | – | – | – | – |
| Nitrofurantoin | 132 | 91.7% | 131 | 87.8% | 94 | 88.3% | 0.65 (0.29–1.47) | 0.303 | 0.69 (0.28–1.66) | 0.402 |