Background: Urinary tract infection is the most common hospital-acquired infection. UTIs are infections of the urethra (urethritis), bladder (cystitis), or kidney (pyelonephritis). It is among the most common infections worldwide, with substantial morbidity, mortality, and economic burden. Fungal species are unusual causes of urinary tract infection in healthy individuals, but are common in the hospital setting or among patients with predisposing diseases and structural abnormalities of the kidney and collecting system. Burn patients are susceptible to nosocomial infections owing to the immunocompromising effects of burn injury, cutaneous and respiratory tract injury, prolonged intensive care unit stays and broad-spectrum antibiotic therapy.
Objective: The study aims to determine the prevalence of
fungal urinary tract infection, the most common fungal species, and possible
risk factors that may increase the occurrence of infection in burn patients.
Materials and Methods: A prospective study of 150 selected
burn patients attending the Medical City Burn Centre in Baghdad from February
2015 to January 2017 was conducted. The study population includes adult
patients of both genders who presented with different percentages of body
burns. Urine sample was collected from each patient at the time of admission
and weekly thereafter for 6 weeks and sent for general urine examination and
urine culture to test for the possibility of fungal growth. Those who were
found to develop fungal UTI by urine culture during their hospitalisation and
had no infection at the time of admission were selected as subjects for our
study. Informed consent was obtained from each participant before sample
collection. Data on patient demographics, underlying diseases, previous and
concurrent infections, antibiotic and immunosuppressive therapy, urinalysis
results, urinary tract instrumentation, and duration of hospitalisation were
collected from patients.
Results: 28 (18.6%) patients had positive fungal culture
during their hospitalisation, 11 of them were males and 17 were females, the
most common age of presentation was 41-50 years and the mean age ± SD was (44.4
± 10.7) years. The most common isolated fungi were Candida albicans (64.3%), followed by Candida glabrata (21.4%) and Candida
tropicalis (7.1%). The majority of patients developed infection within the
2nd and 3rd weeks of hospitalisation, however, those who presented with total
body surface area burned > 40% developed an earlier infection within the 1st
week. Female gender, urethral catheterisation and diabetes mellitus were
significantly associated with higher risk of infection as the P values were
0.03, 0.005 and 0.004, respectively. In burn patients' management, infection
with systemic sepsis is the most important consideration. This systemic sepsis
resulting from invasive infection remains the most common cause of high
mortality rates among patients with major body burns.
Conclusion: Fungal urinary tract infection occurred in 18.6%
of burn patients. The most common causative fungi are Candida species. Advanced
age, female gender, high percentage of body burn, urethral catheterisation and
diabetes mellitus were identified as the most common risk factors of such
infection.
Author (s) Details
Suad Yousuf Aldorkee
Department of Pathological Analysis Technology, Ibn Hayan University
College, Iraq.
Mohammed F. Al. Jawed
Department of Pathological Analysis Technology, Ibn Hayan University
College, Iraq.
Please see the book here:- https://doi.org/10.9734/bpi/dhrd/v10/5261
No comments:
Post a Comment