[Etiology, risk factors, and outcome of urinary tract infection].

OBJECTIVES: To determine the incidence and variety of microorganisms of positive urine culture in patients of intensive care units of Kaunas University of Medicine Hospital and to estimate the risk factors for colonization, development of urinary tract infection, and outcome during the period of 2003-2004. MATERIAL AND METHODS: We retrospectively reviewed patients with a positive urine culture with or without clinical symptoms of urinary tract infection admitted to an intensive care unit. RESULTS: The growth of microorganisms was determined in urine of 82 (3.9%) patients: urinary tract infection in 64 (78%) and colonization in 18 (22%) patients. Among pathogens of urinary tract infection rods predominated significantly (p<0.05). No significant difference was found among colonizing microorganisms (p>0.05). E. coli in urine culture was obtained exclusively in cases of urinary tract infection. All patients with a positive urine culture had catheterized urinary bladder (p<0.05). No influence of age, sex, or duration of catheterization alone on the occurrence of urinary tract infection, colonization, or outcome was found (p>0.05). In cases of the same sex, age, and underlying disease of the patients, the risk of urinary tract infection with every day of catheterization significantly increased by 21.7% (p<0.05). Among patients with lethal outcome there was a significant prevalence of rods in urine culture (p<0.05). In survivors, no significant pathogen was detected in urine culture (p>0.05). In cases of the same sex, age, underlying disease, and duration of catheterization, the development of urinary tract infection significantly increased the risk of lethal outcome by 5.5 times (p<0.05). CONCLUSIONS: Positive urine culture was found in 3.9% of patients, three-quarters of them were due to urinary tract infection. Rods were the predominant pathogens in urinary tract infection. E. coli in urinary tract always resulted in urinary tract infection. Catheterization of urinary bladder resulted in urinary tract infection or colonization. Each day of urinary bladder catheterization increased the risk of development of urinary tract infection by 21.7%. Rods in urine culture were associated with lethal outcome. Development of urinary tract infection increased the risk of lethal outcome 5.5 times.