الفهرس 
Urinary Tract InfectionOnly 14 pages are availabe for public view
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Abstract
The frequency of UTI generates a significant
workload for the laboratory. Most specimens sent to a
laboratory will show no evidence of infection when tested,
and consequently, there has been considerable interest in
ways to screen out specimens before processing them for
culture by a rule-out test strategy as microscopic
examination of urine and dipstick urinalysis testes.
This work aimed at evaluating the performance of
simple screening methods as microscopic urine analysis
and dipstick tests for urine leukocyte esterase and nitrite in
order to use the negative results of these methods as rule
out tests to exclude catheter associated urinary tract
infections in hospitalized patients in Kobry El-kobah
Military Hospital. Moreover, the antimicrobial profile of
the isolated pathogens was determined to help guiding
empirical antimicrobial therapy.
The present study was conducted on 60 hospitalized
patients. All patients were hospitalized in different ICUs of
Kobry Elkobah Military Hospital. All patients were
catheterized by indwelling urinary catheters ≥48 hours.
Catheterized urine samples were collected from all
patients and subjected to culture on suitable media,
microscopic examination of Gram stained films for
bacteriuria, microscopic examination of wet preparations
from uncentrifuged urine and from the urine deposit for pus
cells and dipstick testing for leukocyte esterase and nitrite.
All isolated organisms were identified and tested for
antibiotic susceptibility by disc diffusion method. Isolated
Summary and Conclusion
103
Gram negative bacilli were tested for ESβLs production by
combined disc method.
E-coli was the most prevalent isolate responsible for
CAUTIs among the studied cases, followed by Candida
spp., and klebsiella pneumonia.
Dipstick testing for leukocyte esterase had a higher
performance quality than microscopic examination of urine
samples for detection of pus cells.
Microscopic examination of Gram stained films of
uncentrifuged urine had the highest performance in relation
to microscopic examination of wet preparations made from
centrifuged or uncentrifuged urine for diagnosis of CAUTI.
Considering the negative results of two screening tests
increased the performance quality to rule out UTI in
catheterized patients. The negative results of dipstick
testing and microscopic examination of Gram stained films
are the best among other test combinations to rule out
CAUTI in our study.
Although a high pattern of antimicrobial resistance
was encountered among different isolates, susceptibility
was high to Imipenem in most isolates, followed by
Nitrofurantoin for E-coli and klebsiella pneumoniae, and
Amikacin for Pseudomonas aeruginosa. Enterococci were
highly sensitive to Vancomycin, Rifampicin and
Chloramphenicol although they were resistant to other
tested antibiotics. ESBLs producing species were 65.62%
of all isolated Gram negative bacilli.