Study on Catheter-Associated Urinary Tract Infection (CAUTI): Incidence and Microbiological Profile in a Tertiary Care Hospital in Andhra Pradesh

Abstract

Background: The etiological agents of catheter-associated urinary tract infection (CAUTI) are sundry and often multidrug-resistant. An early, appropriate antimicrobial therapy based on culture sensitivity report and implementation of infection control practices together play a key role in the management of CAUTI.

Objectives: 1. To find the incidence of CAUTI in intensive care unit (ICU) patients.
2. To identify etiological agents responsible for CAUTI.
3. To determine antimicrobial susceptibility pattern for bacterial agents obtained.

Methods: Urine samples from clinically suspected cases of CAUTI were obtained from patients with urinary catheters admitted in ICUs. Urine samples were subjected to wet mount, culture, and sensitivity testing. Responsible pathogens and their antimicrobial susceptibility pattern were obtained based on CSLI standards.

Results: A total of 640 patients were having an indwelling urinary catheter with an aggregate of 5199 catheter-days in 6 months duration. 19 were culture positive out of 45 clinically suspected cases of CAUTI. The CAUTI rate was 3.65 cases per 1000 catheter days. The most predominant etiological agents responsible for CAUTI were Citrobacter species (26.3%) followed by P. aeruginosa (21.1%) and E. coli (21.1%). 2(18.2%) ESBL producing Gram-negative bacteria were obtained among Enterobacteriaciae. The most effective antibiotics were ceftazidime/clavulinic acid, colistin, and meropenam for Enterobacteriaciae; piperacillin/tazobactam for P. aeruginosa; linezolid and vancomycin for Enterococcus species.