engleski

Urosepsis in patients hospitalized at the University Hospital for Infectious Diseases "Dr Fran Mihaljevic" in Zagreb during 2009

Altogether 301 patients with urosepsis were hospitalized at the University Hospital for Infectious Diseases "Dr Fran Mihaljevic" in Zagreb during 2009, comprising a total of 47% patients with sepsis. These were mostly cases of secondary, community acquired sepsis, often a consequence of complicated and recurrent urinary tract infections (UTI). Mostly elderly patients (223 ; 74%) were hospitalized, older than 60 years of age, with some of the risk factors present in over 60% of cases. The disease occurred more frequently in women (68, 44%). Enterobacteria were isolated in 276 (62, 30%) samples, most commonly E.coli (41, 76%), K. pneumoniae (9, 54%) and P. mirabilis (8, 35%). Enterobacterial resistance to co- amoxiclav was 11, 96%, ceftriaxone 17, 75%, cefuroxime 20, 29%, ciprofloxacin 25, 72%, gentamicin 13, 04%, co-trimoxazole 37, 32% and nitrofurantoin 25%. The resistance of a single most common pathogen, E.coli, was within expected levels, to amoxicilin 58, 70%, co- trimoxazole 29, 19%, co-amoxiclav 4, 32% with intermediate susceptibility of 10, 27% and to ciprofloxacin 16, 22%. The therapy in the majority of patients was started as empirical, parenteral, and was continued according to antibiogram results, so that the most commonly administered drug was co-amoxiclav and II and III generation cephalosporins. The majority of urosepsis cases were classified as moderately severe sepsis in 74%, while septic shock was recorded in 18% of patients. In the majority of patients the outcome of treatment was favorable, so that 87% of patients were discharged from hospital as improved or cured, while 13% of the patients died.

urosepsis; risk factors; antibiotic sensitivity

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