Comparison of resistant microorganism isolation and complicating factors in patients with urinary tract infections managed as outpatients and inpatients

Objective: In our study, we aim to evaluate the type of urinary tract infection (UTI), complicating factors and risk factors in patients diagnosed with UTI and compare the biochemical urine analyses and urine cultures used in rapid diagnosis between the two groups. Materials and Methods: A retrospective study was conducted on patients diagnosed with urinary tract infection (UTI) who were admitted to the Infectious Diseases and Clinical Microbiology Department of Balıkesir University Health Application and Research Hospital between 01.01.2022 and 01.02.2024, either as inpatients or outpatients. The clinical and demographic characteristics of the patients were compared in terms of whether the pathogen in their urine culture produced extended-spectrum beta-lactamase (ESBL) or exhibited multidrug resistance (MDR). The statistical analysis of the data was performed using the Statistical Package for the Social Sciences (SPSS) for Windows version 25.0. Results: A total of 328 patients diagnosed with urinary tract infection (UTI) were included in our study. Of these, 62,8% (n=206) were treated as outpatients, and 37,2% (n=122) were hospitalized. It was observed that the hospitalization rate was higher in males compared to females (p=0.02). The most commonly detected pathogens in urine cultures were Escherichia coli (40,4%), Klebsiella spp. (22,1%), and Pseudomonas spp. (13,4%). Among the 230 patients with positive urine cultures, 57,9% were found to be ESBL positive, while 42,1% were ESBL negative. Male gender, chronic kidney disease, urolithiasis, history of urological interventions, antibiotic use, hospital admission, and a history of UTIs were identified as risk factors for ESBL-positive microorganisms. Pseudomonas spp. exhibited a higher rate of MDR compared to other microorganisms, and complicated UTIs had a higher rate of MDR compared to uncomplicated UTIs. Conclusion: Considering the increasing frequency of urinary tract infections (UTIs) and antibiotic use, accurate diagnosis, detailed evaluation of complicating factors, appropriate antibiotic therapy, follow-up methods, and surveillance are crucial. In this study, evaluations were made within our patient group for these purposes. Keywords: Urinary tract infection, antimicrobial resistance, multidrug resistance