1988 Volume 62 Issue 12 Pages 1111-1120
We studied retrospectively the hospital acquired P. aeruginosa infection of the urinary tract in hospitalized patients with urological disease during the 12 years from 1976 to 1987.
The results were as follows:
1. P. aeruginosa was isolated with the highest frequency in 1976 (15.9%, 46/289 Pts.) for hospitalized patients with urinary tract infection. Various preventive measures decreased this frequency to 5.1%(15/291 Pts.) by 1987.
2. P. aeruginosa was isolated with the highest frequency among patients with complicated urinary tract infection, in those with indwelling catheters (14.3%, 50/350 Pts.).
3. P. aeruginosa in feces was isolated from 1.4%-13.9% of the patients at the time of admission, increasing up to 5.0%-20.7% at discharge. However, these rates tended to decrease in recent years.
4. The annual changes of serotype distribution of P. aeruginosa isolated from urine and feces were similar. Although serotype C, E and G were dominant in 1976 and 1977, serotype A, B and G became dominant since 1978, with serotype E decreasing remarkably.
5. During hospitalization, urinary tract infection was found in 16.9%(12/71 Pts.) of the patients with P. aeruginosa isolated in their feces at the time of admission. In contrast, only 5.7%(157/2747Pts.) of those without P. aeruginosa in their feces had the infection during hospitalization. The rate of urinary tract infection (16.9%) decreased to 2.0%(2/99 Pts.) when oral administration of Polymyxin-B eliminated the P. aeruginosa isolated from feces at the time of admission.
6. Among the patients without P. aeruginosa in their feces at the time of admission, the higher isolation rate (15.1%, 28/186 Pts.) of P. aeruginosa in feces at discharge was observed in those having urinary tract infection upon admission than (5.1%, 122/2409 Pts.) those without it at that time.
7. Comparing the serotype of P. aeruginosa isolated from urine with feces, the identical serotype was found in 38.9%(21/54 Pts.) of the patients with both urinary and fecal P. aeruginosa. This result suggested that appoximately 40% of acquired hospital infection of P. aeruginosa was caused by self infection, while the remaining 60% was by cross infection.