MICROBIAL EVALUATION OF CATHETER ASSOCIATED UTI IN PATIENTS ADMITTED TO SURGICAL ICU OF A TERTIARY CARE HOSPITAL

Abstract

BACKGROUND: Catheter-associated urinary tract infection (CAUTI) is one of the most common nosocomial infection. The antimicrobial resistance pattern varies over time and place. As no similar study had been undertaken in SICU of our hospital, so this study was conducted to know the prevalence of CAUTI, the causative pathogens with their antimicrobial susceptibility and to find the associated risk factors.

OBJECTIVES: The find the prevalence of CAUTI cases, identify and note the sensitivity pattern of associated microorganisms.

STUDY DESIGN: Cross-sectional study.

PARTICIPANTS: Patients with fever > 100.4°F and indwelling catheter for >48 hrs.

METHODS: A total of 280 urine samples were collected. Culture and antibiotic susceptibility patterns were done. Antifungal sensitivity of yeast isolates was done by VITEK2 Compact System. Bio-data and clinical data was obtained.

RESULTS: Prevalence of CAUTI was found to be 27.5%. 78 microorganisms were isolated, (57 bacteria and 21 yeast). A.baumannii was the most common Gram-negative bacilli(4.2%) found followed by E.coli(3.57%), K.pneumoniae(2.86%) and P. aeruginosa; 7 (2.5%).Enterococcus spp. (5.7%) was the most common Gram-positive cocci. Candida glabrata (2.8%), was the predominant yeast found followed by Candida albicans (2.1%) and Candida tropicalis (1.42%).

All bacterial pathogens recovered were resistant to most of the antimicrobials tested. The Gram-negative isolates showed uniform sensitivity (100%) to polymyxin B. All Gram-positive isolates were sensitive to Linezolid. Yeasts were sensitive to most of the antifungals tested.

Increased duration of catheterization, advanced age, diabetes mellitus, hypertension and underlying trauma were found to be significantly associated with CAUTI.

CONCLUSION: Length of catherization was found to be an important risk factor. Females were affected more than males. The causative pathogens were mostly Gram-negative bacilli. Most of the bacterial pathogens were found to be Multi-drug resistant.

IMPLICATIONS: Knowledge about prevalence of CAUTI ,the microorganisms associated, with their antibiotic susceptibility can prove useful to find appropriate antimicrobial agents for prophylaxis and empiric therapy and to implement the infection control system in a proper manner.