A clinical study to assess the incidence of catheter associated urinary tract infections (CAUTI) by leukouria and nitrite analysis using dipstick urinalysis in tertiary health facility in Jos, Nigeria

Abstract

Insertion of a catheter carries a high risk, with daily incidence of bacteriuria of 3 to 10%. Between 10 and 30% of patients who undergo short-term catheterization (i,e, 2 to 4 days) develop bacteriuria and are asymptomatic. Between 90 and 100% of patients who undergo long-term catheterization develop bacteriuria. About 80% of nosocomial UTIs are related to urethral catheterization; only 5 to 10% are related to genitourinary manipulation. The objective of this study is to assess the incidence of Catheter Associated Urinary Tract Infection by Leukouria and Nitrite analysis using dipstick urinalysis. A cross sectional study was conducted at the Plateau Specialist Hospital, Jos, Plateau State, Nigeria. It was conducted amongst 33 subjects who were on hospital admission in the medical or surgical wards within the time of this study. All subjects were on Urinary Catheter. Some of them were catheterized in the hospital, others were referred cases, brought in on urinary catheters. Samples were obtained using a 20 ml syringe from the sample ports of the catheters. Combi-11 dipstick (Cybow TM) reagent strips were used for the urine analysis. Results were recorded immediately. The results showed that 84.8% of catheterized patients had detectable Leukouria, 76.9% of surgical patients had detectable Leukouria and 85% medical patients had detectable Leukouria. 92.9% of elderly patients had detectable leukouria levels on urinalysis. Thus, more medical patients are at risk of developing UTI before surgical patients. The average time to first detectable Leukouria was 6 days. Women developed CAUTI before men. 71.4% of elderly patients had moderate to high Leukouria within 7 days. Catheter Associated Urinary Tract Infections are one of the commonest nosocomial infections occurring in our society. Appropriate urinary catheter care should be ensured and it is changed regularly. Complete avoidance of urethral catheterization possible is still the Gold standard to CAUTI prevention.