Milovanovic, Tamara (55695651200)Tamara (55695651200)MilovanovicDumic, Igor (57200701725)Igor (57200701725)DumicVeličkovic, Jelena (29567657500)Jelena (29567657500)VeličkovicLalosevic, Milica Stojkovic (57218133245)Milica Stojkovic (57218133245)LalosevicNikolic, Vladimir (57192426202)Vladimir (57192426202)NikolicPalibrk, Ivan (6507415211)Ivan (6507415211)Palibrk2025-06-122025-06-122019https://doi.org/10.1186/s12879-019-3761-5https://www.scopus.com/inward/record.uri?eid=2-s2.0-85061511864&doi=10.1186%2fs12879-019-3761-5&partnerID=40&md5=176e6feb4c3052b95f7cdc36ffe09cb0https://remedy.med.bg.ac.rs/handle/123456789/5710Background: Cirrhosis-associated immune dysfunction syndrome (CAIDS) has been identified in patients with liver cirrhosis (LC), predisposing them to a wide variety of infections. In patients with LC, healthcare-associated infections involving multi-drug resistant (MDR) bacteria have increased significantly over the last decades. Among them, hospital-acquired urinary tract infections (HA-UTI) are the most common. This study aimed to investigate the rates of antimicrobial resistance among patients with LC and HA-UTI and to determine risk factors associated with their development among patients hospitalized in tertiary care facility in Serbia. Methods: This retrospective study included 65 hospitalized patients with LC who had developed HA-UTI. We examined the epidemiology of these infections concerning resistance to the most commonly used antimicrobials and patient-specific risk factors associated with HA-UTI development by MDR pathogens. Results: The most frequently isolated organisms were Enterococcus spp. (n = 34, 52.3%), Klebsiella spp. (n = 10, 15.4%), and E.coli (n = 6, 9.2%). Thirty-five isolates (53.8%) were identified as MDR, and 30 (46.2%) were non-MDR.We found a statistically significant difference in the distribution of MDR and non-MDR strains, based on Gram staining, with the majority of Gram-negative pathogens being MDR (p = 0.005). We identified age ≥ 65 years (p = 0.007), previous use of cephalosporins as empiric therapy (p = 0.042), and the presence of hepatic encephalopathy (p = 0.011) as independent risk factors for the development of MDR UTIs. Conclusion: This is the first study from Serbia and the Balkans concerning the changing epidemiology of MDR UTI in patients with LC. Our study showed that more than half of HA-UTI was caused by MDR and the most common pathogen was Enterococcus spp. The overall resistance to ceftriaxone was 92%. Our findings underscore the need for institutions to individualize protocols for treatment of hospital-acquired infections, particularly in immunocompromised populations. © 2019 The Author(s).Immune dysfunctionLiver cirrhosisMulti-drug resistant organismUrinary tract infection