Introduction:Pseudomonas aeruginosa is a uropathogen that is mainly involved in nosocomial infection. The aim of this study was to analyze the antimicrobial susceptibilities and clinical characterization of P. aeruginosa isolates from urinary tract infections (UTIs). Materials and Methods: The study collected all P. aeruginosa UTI strains from a hospital in Chongqing, China, from January 1st, 2010 to December 31st, 2011. The antibiotic susceptibilities of the P. aeruginosa isolates were analyzed using the agar dilution method and the genotypes were assessed using random amplification of polymorphic DNA-PCR (RAPD-PCR). The clinical characteristics of the patients with UTIs were collected from the hospital information systems, and significance was analyzed using the proportion test. Results: A total of 2,778 episodes of culture-proven UTIs were used in the study. There were 198 infections (7.1%) caused by P. aeruginosa. P. aeruginosa strains were highly resistant to most drugs tested. The RAPD-PCR data revealed that the 198 P. aeruginosa infections had 82 different genotypes. Antibacterial use, previous UTI, urinary tract catheter and urinary tract operation were found to be risk factors for the development of UTIs. Conclusions:P. aeruginosa is the second most common UTI pathogen in our hospital. We should closely monitor patients with risk factors for P. aeruginosa infection.

1.
Mittal R, Aggarwal S, Sharma S, Chhibber S, Harjai K: Urinary tract infections caused by Pseudomonas aeruginosa: a minireview. J Infect Public Health 2009;2:101-111.
2.
Bermingham SL, Ashe JF: Systematic review of the impact of urinary tract infections on health-related quality of life. BJU Int 2012;110(11 Pt C):E830-E836.
3.
Rosenthal VD, Dwivedy A, Calderon ME, Esen S, Hernandez HT, Abouqal R, Medeiros EA, Espinoza TA, Kanj SS, Gikas A, Barnett AG, Graves N; International Nosocomial Infection Control Consortium (INICC) Members: Time-dependent analysis of length of stay and mortality due to urinary tract infections in ten developing countries: INICC findings. J Infect 2011;62:136-141.
4.
Rosenthal VD, Maki DG, Jamulitrat S, Medeiros EA, Todi SK, Gomez DY, Leblebicioglu H, Abu Khader I, Miranda Novales MG, Berba R, Ramírez Wong FM, Barkat A, Pino OR, Dueñas L, Mitrev Z, Bijie H, Gurskis V, Kanj SS, Mapp T, Hidalgo RF, Ben Jaballah N, Raka L, Gikas A, Ahmed A, Thu le TA, Guzmán Siritt ME; INICC Members: International Nosocomial Infection Control Consortium (INICC) report, data summary for 2003-2008, issued June 2009. Am J Infect Control 2010;38:95-104.
5.
Rossolini GM, Mantengoli E: Treatment and control of severe infections caused by multiresistant Pseudomonas aeruginosa. Clin Microbiol Infect 2005;11(suppl 4):17-32.
6.
Matsumoto T, Hamasuna R, Ishikawa K, Takahashi S, Yasuda M, Hayami H, Tanaka K, Kiyota H, Muratani T, Monden K, Arakawa S, Yamamoto S: Nationwide survey of antibacterial activity against clinical isolates from urinary tract infections in Japan (2008). Int J Antimicrob Agents 2011;37:210-218.
7.
Al Benwan K, Al Sweih N, Rotimi VO: Etiology and antibiotic susceptibility patterns of community- and hospital-acquired urinary tract infections in a general hospital in Kuwait. Med Princ Pract 2010;19:440-446.
8.
Mathai D, Jones RN, Pfaller MA; SENTRY Participant Group North America: Epidemiology and frequency of resistance among pathogens causing urinary tract infections in 1,510 hospitalized patients: a report from the SENTRY Antimicrobial Surveillance Program (North America). Diagn Microbiol Infect Dis 2001;40:129-136.
9.
Yamamichi F, Shigemura K, Matsumoto M, Nakano Y, Tanaka K, Arakawa S, Fujisawa M: Relationship between urinary tract infection categorization and pathogens' antimicrobial susceptibilities. Urol Int 2012;88:198-208.
10.
Venier AG, Lavigne T, Jarno P, L'Heriteau F, Coignard B, Savey A, Rogues AM: Nosocomial urinary tract infection in the intensive care unit: when should Pseudomonas aeruginosa be suspected? Experience of the French national surveillance of nosocomial infections in the intensive care unit, Rea-Raisin. Clin Microbiol Infect 2012;18:E13-E15.
11.
Wu Z, Wu Z: Surgery, ed 7. Beijing, People's Medical Publishing House, 2008.
12.
Clinical and Laboratory Standards Institute: Performance Standards for Antimicrobial Susceptibility Testing: Twentieth Informational Supplement M100-S20. Wayne, CLSI, 2010.
13.
Nazik H, Ongen B, Erturan Z, Salcioğlu M: Genotype and antibiotic susceptibility patterns of Pseudomonas aeruginosa and Stenotrophomonas maltophilia isolated from cystic fibrosis patients. Jpn J Infect Dis 2007;60:82-86.
14.
Giske CG, Libisch B, Colinon C, Scoulica E, Pagani L, Füzi M, Kronvall G, Rossolini GM: Establishing clonal relationships between VIM-1-like metallo-beta-lactamase-producing Pseudomonas aeruginosa strains from four European countries by multilocus sequence typing. J Clin Microbiol 2006;44:4309-4315.
15.
Bitsori M, Maraki S, Koukouraki S, Galanakis E: Pseudomonas aeruginosa urinary tract infection in children: risk factors and outcomes. J Urol 2012;187:260-264.
16.
Tabibian JH, Gornbein J, Heidari A, Dien SL, Lau VH, Chahal P, Churchill BM, Haake DA: Uropathogens and host characteristics. J Clin Microbiol 2008;46:3980-3986.
17.
Kumar MS, Lakshmi V, Rajagopalan R: Occurrence of extended spectrum beta-lactamases among Enterobacteriaceae spp. isolated at a tertiary care institute. Indian J Med Microbiol 2006;24:208-211.
18.
Khan AU, Musharraf A: Plasmid-mediated multiple antibiotic resistance in Proteus mirabilis isolated from patients with urinary tract infection. Med Sci Monit 2004;10:CR598-CR602.
19.
Ozumba UC: Urinary tract infections in children due to Pseudomonas aeruginosa in Enugu, Nigeria. J Trop Pediatr 1998;44:315-316.
20.
Goldman M, Rosenfeld-Yehoshua N, Lerner-Geva L, Lazarovitch T, Schwartz D, Grisaru-Soen G: Clinical features of community-acquired Pseudomonas aeruginosa urinary tract infections in children. Pediatr Nephrol 2008;23:765-768.
21.
Romero Cullerés G, Sugrañes JC, Planells Romeo I, Giménez Pérez M: Characteristics of urinary tract infections in different patient subpopulations and depending on the bladder emptying system. Actas Urol Esp 2010;34:251-257.
22.
Gad GF, el-Domany RA, Ashour HM: Antimicrobial susceptibility profile of Pseudomonas aeruginosa isolates in Egypt. J Urol 2008;180:176-181.
23.
Marcus N, Ashkenazi S, Samra Z, Cohen A, Livni G: Community-acquired Pseudomonas aeruginosa urinary tract infections in children hospitalized in a tertiary center: relative frequency, risk factors, antimicrobial resistance and treatment. Infection 2008;36:421-426.
24.
Narten M, Rosin N, Schobert M, Tielen P: Susceptibility of Pseudomonas aeruginosa urinary tract isolates and influence of urinary tract conditions on antibiotic tolerance. Curr Microbiol 2012;64:7-16.
25.
Shigemura K, Arakawa S, Sakai Y, Kinoshita S, Tanaka K, Fujisawa M: Complicated urinary tract infection caused by Pseudomonas aeruginosa in a single institution (1999-2003). Int J Urol 2006;13:538-542.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.