ĐẶC ĐIỂM NHIỄM KHUẨN ĐƯỜNG TIẾT NIỆU TẠI KHOA NỘI THẬN BỆNH VIỆN CHỢ RẪY

Abstract

Objectives: To describe the clinical and laboratory characteristics and in-hospital outcomes of patients with urinary tract infections (UTIs) treated at the Nephrology Department, Cho Ray Hospital.

Materials and Methods: A retrospective, cross-sectional study was conducted on medical records of inpatients diagnosed with UTIs at the Nephrology Department, Cho Ray Hospital, from January 2024 to July 2024.

Results: The mean age was 56,5 ± 17,83 years old; the 46-65 age group accounted for 38,4%, and those over 65 accounted for 36,6%. Females comprised 64,3% of the study population. Common risk factors for UTI included diabetes mellitus (35,7%), a history of kidney or ureteral stones (31,3%), and prostatic hypertrophy (15,2%). The most frequent reasons for admission were fever (37,5%), abdominal pain (13,4%), and dysuria (11,6%). Common clinical symptoms included fever (39,3%), flank pain (24,1%), dysuria (40,2%), urinary frequency (12,5%), and abdominal pain (14,3%). At the time of admission, 38 patients (33,9%) presented with shock. The median length of hospital stay was 6,9 ± 4,91 days. Eight patients (7,14%) had severe outcomes (discharged due to worsening condition or in-hospital death). Abdominal CT scans were performed on 65 patients (58%), revealing common lesions such as hydronephrosis (40,2%), perirenal fat stranding (12,5%), renal/ureteral stones (23,6%), and renal abscess (4,5%). The proportion of positive urinary leukocyte esterase was 70,5%, while nitrite positivity was observed in 15,2% of cases. There were 20 patients with positive urine cultures (17,9%), with Gram-negative bacteria being predominant (75%), primarily E. coli (60%). E. coli showed high sensitivity to tigecycline (83,3%), carbapenems (75%), and nitrofurantoin (66,7%), but 100% resistance to quinolone  (including ciprofloxacin and levofloxacin). The prevalence of ESBL-producing E. coli was very high at 91,7%.

Conclusions: Urinary tract infections present with diverse clinical symptoms. Patients with UTIs admitted to Cho Ray Hospital often present shock. The rate of positive urine cultures remains low, while the prevalence of antibiotic-resistant bacteria is high.