Microbiological Evaluation of Catheter Associated Urinary Tract Infection in a Tertiary Care Hospital

Urinary tract infections are the most common type of healthcare-associated infection, accounting for more than 30% of infections reported by acute care hospitals. Virtually all healthcare-associated UTIs are caused by instrumentation of the urinary tract. Catheter-associated urinary tract infection (CAUTI) has been associated with increased morbidity, mortality, hospital cost and length of stay. In addition, hospital acquired CAUTIs are often due to multidrug resistant strains which require higher antibiotics and these strains may spread to other patients. Urine samples from all adult patients admitted without any recent history of UTI and where a Foley's catheter was introduced in the past 24 hours is aseptically collected, analysed by microscopy and cultured for microbiological profiling. Antibiogram of clinical isolates was studied and CAUTI was observed in 64 samples out of 220 samples collected. The most frequent isolates were E.coli (34.85%), Klebsiella spp (19.7%), Pseudomonas spp (12.12%), Candida spp (10.6%), Enterococcus spp (6.06%), CONS (6.06%), Staphylococcus aureus (4.55%), Citrobacter spp (3.03%) Proteus spp (3.03%). Infections were more with female sex, prolonged catheterization, old age and diabetes. Longer duration of catheterization increased the chances of CAUTI. Emphasis should be placed on good catheter management rather than the use of prophylaxis to reduce the incidence of CAUTI. ABSTRACT