臨床感染症: オープンアクセス

Management of Urinary Tract Infections in Adults Hospitalized at Departmental and Teaching Hospital of Borgou-Alibori: Retrospective Analysis from 2013 to 2022

Abstract

Attinsounon Cossi Angelo*, Fiogbé Sedami Eudoxie, Dovonou Comlan Albert, Alassani Adébayo, Saké Khadidjath, Adé Sènan Serge and Adoukonou Thierry

Introduction: Urinary Tract Infections (UTIs) are community-acquired infections frequently encountered in hospitals. The aim of this study was to investigate the diagnostic, therapeutic and evolutionary aspects of urinary tract infections among hospitalized patients in the internal medicine department of DTH-BA.

Methods: This was a descriptive cross-sectional study that systematically included all patients hospitalized for urinary tract infection from January 1^st, 2013 to December 31, 2022. Data on diagnosis, treatment and outcome were collected from patient’s medical records. A team of experts (infectiologist and microbiologist) assessed the quality of antibiotic therapy (justification, relevance of choice, appropriateness). This study was approved by the local biomedical research ethics committee of the University of Parakou. Data were analyzed using SigmaPlot 14.0 software.

Results: A total of 2876 records were analysed, with 183 cases of urinary tract infection, representing a frequency of urinary tract infection in hospitalized patients of 6.36%. The sex ratio was 0.74 and the mean age 40.55 ± 17.53 years. The most common symptoms were fever (134 cases; 73.22%), asthenia (93 cases; 50.82%) and urinary burning (82 cases; 44.81%). The diagnosis was pyelonephritis in 71 (38.80%) patients, acute cystitis in 68 (37.16%) patients and male urinary tract infection in 42 (22.95%) patients. Of 173 (94.54%) Urine Dipsticks (UD) performed, 159 (91.91%) were positive. A Urine Cytobacteriological Examination (UCE) was performed in 37 (20.22%) patients, 32 (86.49%) of them after initiation of antibiotic therapy. A germ was identified in 15 cases (40.54%). Escherichia coli was the most frequent germ (8 cases; 53.33%). In terms of treatment, 182 (99.45%) patients received probabilistic antibiotic therapy, with 133 (73.08%) patients receiving inappropriate management and 14 (93.33%) of the 15 who received an antibiotic susceptibility test being unsuitable. One hundred twenty-four (67.76%) patients were cured, 10 (5.46%) died and 49 (26.78%) were discharged against medical advice.

Conclusion: This study shows that urinary tract infections are managed with probabilistic and inappropriate antibiotics. This result should prompt the development of a protocol for the management of these infections, to ensure the correct use of antibiotics in this department.