Carbapenem resistant Enterobacteriaceae urinary tract infections

The aim of our work is to describe the particularities of carbapenem-resistant Enterobacteriaceae (CRE) urinary tract infections as well as the selection factors of these resistant strains. This is a retrospective descriptive study including all patients hospitalized within the wards of CHU Taher Sfar Mahdia (2015- 2018) who had presented with ERC urinary tract infection. Twenty-three patients were collected. Their mean age was 57.3 years, with a sex ratio M/F=0.77. The infection was healthcare-associated in 56.5% of cases. The main risk factors for acquiring CRF were: previous antibiotic therapy (beta-lactams), previous hospitalization, an invasive procedure within the previous six months respectively, and a history of UTI within the previous year. The most frequently isolated germ was Klebsiella pneumoniae (69.5%). A combination of antibiotics was indicated in 19 cases (82.6%). Prescription of tigecycline was significantly associated with an unfavorable outcome (p=0.032). Intervention strategies need to be integrated, targeting decision-makers, prescribers and patients alike.