Evaluation of urinary tract infection agents in intensive care unit patients and monitoring of antimicrobial profile in Gram-negative bacteria

Background: urinary tract infection is one of the most common complications in intensive care patients. This study aimed to determine the microorganisms grown in the urine cultures of patients treated in the intensive care units of our hospital and to evaluate the resistance status of the isolated Gram-negative bacteria to antibiotics. Materials and Methods: the distribution of microorganisms isolated from urine cultures of intensive care patients in our hospital’s microbiology laboratory between January 2018 and December 2022 and the resistance patterns of Gram-negative bacteria to antibiotics were evaluated retrospectively. Results: there was significant growth in 391 (21%) of 1855 urine cultures. 84.6% (n=331) of the samples belonged to patients treated in the general intensive care unit. Gram-positive bacteria were found in 9.4% (n=37), Candida species in 28.9% (n=113), and Gram-negative bacteria in 61.6% (n=241) of the cultures. The most frequently isolated Gram-positive microorganism was Enterococcus spp., while the Gram-negative pathogen was E. coli. Ciprofloxacin resistance was 48.3% in E. coli and 65% in K. pneumoniae, and amoxicillin-clavonic acid resistance was 42.6% in E. coli and 80% in K. pneumoniae. Ciprofloxacin resistance in Proteus and Pseudomonas strains was 53.3% and 52.9%, respectively. All A. baumannii strains were resistant to carbapenem and ciprofloxacin. Conclusions: considering the resistance rates obtained in the study, amikacin is considered an appropriate treatment option for patients in our hospital. Due to high resistance rates, the use of carbapenems and quinolones should be avoided in the treatment of A. baumannii. Carbapenem and amikacin are considered suitable treatment options for the treatment of E. coli and K. pneumoniae strains, and Trimethoprim/Sulfamethoxazole (TMP-SMX) for the treatment of A. baumannii strains.