Catheter associated urinary tract infection in an acute care setting of a tertiary care centre in South India

Abstract

Background: Catheter associated UTI is a serious cause of morbidity and mortality in intensive care unit (ICU) patients. Hence, authors undertook the present study to know the prevalence of catheter associated urinary tract infections (CAUTI) in medical ICU patients of tertiary care centre and to know the antibiotic resistance pattern of the causative organisms.Methods: A one-year prospective study was carried out from September 2015 to August 2016. Demographic data from the catheterized patients were collected daily and scrutinized for the signs and symptoms as per CDC criteria for confirmation as CAUTI. Relevant antimicrobial resistance data of etiologic agents were also collected to ascertain the prevalent resistance pattern.Results: The overall incidence of CAUTI was 14.69 per 1000 catheterized days in the present study. Out of the 37 diagnosed CAUTI cases, 12 (32.4%) were males and 25 (67.6%) were females with maximum patients being between 40 to 60 years of age. The commonest uropathogens was Escherichia coli (n=26) followed by K. pneumoniae (n=5). Both Escherichia coli and Klebsiella pneumoniae isolates were found to be 100% resistant to cefotaxime, ceftazidime and cefuroxime. Pseudomonas aeruginosa and Acinetobacter species were least common etiological culprits and demonstrated complete resistance to all the tested antibiotics.Conclusions: In the present study the prevalence of CAUTI is much higher which needs to be rectified by continuous monitoring and training of the staff in implementation of infection control practices in a proactive manner.

Study of Quinolone-Resistant E.Coli Isolated from Hospital-Acquired Urinary Tract Infection in Intensive Care Units

“…The high sensitivity of E coli isolated from CAUTI specimens to imipenem, Meropenem, and amikacin was also stated by other studies 5,13,14 , while Fahim, 2021 contrary to our study, reported high resistance of E coli samples to carbapenems and amikacin 15 .…”

“…The most frequently isolated organisms from CAUTI samples were E. coli which was isolated in 204 samples (27.4%) followed by Candida (21.2%) and Staph aureus (12.0 %) which matches with Mishra and Rao., 2019 who found E coli to be the commonest microorganism causing CAUTI in their study. 5 Clinical characteristics of patients in our study showed that females were slightly higher (52 %) than males (48 %) which may be attributable to the short urethra of females which eases bacterial colonization 6 .…”

“…Fifty cases resistant to ciprofloxacin underwent susceptibility testing done by broth microdilution method. As shown in Table (5), meropenem was the highest sensitive antibiotic (48.9%) followed by amikacin (47.4%) while cefuroxime (100.0%) and cefaclor (100.0%) are the most resistant antibiotic. --------------------------------------------------------------------------------------------------------------------------------------------------DISCUSSION Urine samples were collected from Intensive care units at Mansoura University Main Hospital over two years between January 2019 and January 2021.…”

Evaluation of Antimicrobial Resistance of Uropathogenes Involved in Urinary Tract Infections in ICU Patients

“…The majority (60-80%) are detected in patients with urinary catheterization. Studies do not report age, sex, disease severity or comorbidities as being significant favorable factors, but the average length of stay in ICU, the duration of catheter use (increased risk by 5% daily) and the conditions of catheter use (there is higher frequency of symptomatic UTIs when urinary catheters were placed in an emergency or in the operating room) [2], [5], [11], [12], [13], [15], [16].…”

“…The results reported in various studies on the antibiotic resistance profiles of isolated germs and the share of multidrugresistant strains vary from one ICU to another. Resistance to beta-lactams is most commonly reported in Enterobacterioaceae P. aeruginosa and Acinetobacter baumannii have high resistance to most antibiotics tested [1], [13].…”