Acute urinary tract infection in patients with underlying benign prostatic hyperplasia and prostate cancer

Abstract

Introduction: the occurrence of urinary tract infection in patients with obstructing prostate causes reduction in their health-related quality of life and overall well-being. The objective of this study was to determine the prevalence, risk factors and antimicrobial sensitivity pattern of pathogens causing urinary tract infection in patients with benign prostatic hyperplasia and prostate cancer.

Methods: all patients who presented to our urology division with bladder outlet obstruction secondary to benign prostatic hyperplasia or prostate cancer between January 2016 and January 2019 were included. Information on age, co-morbid conditions, presence of an indwelling catheter, bacteriologic analysis, imaging findings and histological diagnosis were obtained and analyzed using SPSS version 20.

Results: de-novo urinary tract infection occurred in 35.6% of patients while recurrent infection occurred in 5.9% of them. The most commonly isolated organisms were gram-negative bacteria with Escherichia coli, Klebsiella spp, Citrobacter spp and Aerobacter spp accounting for 62.2%, 27.0%, 8.1% and 2.7% respectively. Nitrofurantoin (64.3%), Ceftriaxone (46.3%) and Genticin (42.9%) were the three most sensitive antimicrobials to the organisms isolated. Only the presence of an indwelling catheter in the bladder was an independent predictor of urinary tract infection in the study population.

Conclusion: about one-third of patients with benign prostatic hyperplasia and prostate cancer develop urinary tract infection. The predominant bacterial cause was Escherichia coli, which had a high degree of sensitivity to Nitrofurantoin. The presence of an indwelling catheter was the only independent predictor of this infection. Appropriate measures should be re-enforced to prevent the occurrence of catheter-associated infections.