Catheter associated urinary tract infections in intensive care units patients in a tertiary care hospital

Abstract

Introduction: Catheter associated urinary tract infections (CAUTI) is the most common health care associated infection (HAI), accounting for 40% of all HAIs in particularly in patients admitted to intensive care units (ICU) due to their more frequent necessity of urinary catheterization and longer duration of catheter use. Knowledge about Microbiological profile and antimicrobial sensitivity pattern of CAUTI is essential to implement the infection control system in a proper manner. Aims and objectives: To study the rate and microbiological profile of catheter associated urinary tract infections and in patients admitted in Intensive Care Units. Materials and methods: A one-year prospective study was conducted in which urine samples were collected from patients admitted in Medical ICUs on indwelling urinary catheter for >48 hours and processed in Microbiology Department according to standard procedures. CA-UTI rate was calculated and their microbiological profile and various resistance patterns were studied as per CLSI guidelines. Results: Out of 1406 enrolled patients, 64 patients developed CAUTI. Overall CAUTI rate was 4.06/1000 catheter days. Most common isolate in CAUTI cases was Klebsiella spp. (32.3%), followed by Escherichia coli (24.6%). Gram negative isolates showed higher sensitivity to aminoglycosides, imipenam and nitrofurantoin as compared to cephalosporins The Enterococcus spp. were 100% sensitive to linezolid and 71.4% sensitive to both vancomycin and teicoplanin. Conclusion: CAUTI rate in our ICUs was high compared to the benchmarks. Antibiotic sensitivity pattern of the pathogens involved was also low. This study provides the data of predisposing risk factors and its causative microbial flora for CAUTI in our tertiary care.