Abstract
Background: This study seeks to identify the prevalence of catheter associated urinary infection and the type of bacteria that are associated with this infection, as well as the antibiotic susceptibility patterns of the organisms isolated. This would guide the choice of antibiotics when there is catheter associated urinary tract infection. Method: From 1 November 2015-31 April 2016 a cross-sectional study was conducted among patients with urinary catheter in-situ. Urine samples collected were processed and cultured on CLED agar plates. Pure colonies of isolated organism were Gram and Biochemically characterized. A disc diffusion antibiotic susceptibility determined by Kirby-Bauer disc diffusion method was performed on each uropathogen isolated. Data obtained was cleaned, analyzed and presented. Result: There were 122 study subjects of which, 73 (59.8%) were males and 49 (40.2%) were females. Their median age was 42.5 (range 33 - 65) years. Significant bacterial growth was obtained in 88 (72.1%) of the urine specimen cultured of which males constituted 48 (54.5%) and females 40 (45.5%). The most prevalent uropathogens isolated were Escherichia coli 41 (46.6%), Klebsiella spp. 18 (20.6%), Pseudomonas aeruginosa 10 (11.4%), Enterobacter spp. 6 (6.8%) and Staphylococcus aureus 5 (5.8%). Bacterial isolates showed some susceptibility to Amikacin 73 (83.0%), Levofloxacin 34 (38.6%) and Ciprofloxacin 26 (29.5%) respectively. The uropathogens were least susceptible to Gentamicin 3 (3.4%), Ampicillin 3 (3.4%) and Cefuroxime 1 (1.1%) respectively. Conclusion: Catheter associated bacterial urinary tract infection (CABUTI) is prevalent at the Tamale Teaching Hospital. Micro bacterial isolates demonstrated substantial decrease in susceptibility to antibiotics commonly used. Understanding the local antibiotic susceptibility pattern could guide the choice of antibiotics used in treating CABUTI.
Highlights
Urinary catheters are passed to permit drainage of urine [1]
Understanding the local antibiotic susceptibility pattern could guide the choice of antibiotics used in treating Catheter Associated Bacteria Urinary Tract Infection (CABUTI)
Included in the top five uropathogens were Escherichia coli 30.5%, Klebsiella pneumoniae 30.5%, Pseudomonas aeruginosa 16.6% and Candida spp. 16.6% as reported by Kazi and colleaques [27]. This present study revealed that Escherichia coli 46.6%, Klebsiella spp. 20.6%, Pseudomonas spp. 11.4%, Enterobacter 6.8% and Staphylococcus aureus 5.8% respectively were the most prevalent CABUTI uropathogens at the Tamale Teaching Hospital
Summary
Urinary catheters are passed to permit drainage of urine [1] They may have diagnostic or therapeutic uses [2]. The risk of bacterial Urinary Tract Infections (UTI) is dependent on the patient’s susceptibility, the quality of catheter and how long catheter has been in place [7] [8]. Catheter Associated Bacteria Urinary Tract Infection (CABUTI) occurs in at least 40% of hospital-acquired infections [9]. CABUTI has been associated with substantial morbidity in acute care settings and extended care facilities at rates of 20% and 50% respectively [8]. CABUTI rates vary widely from up to 5% for single brief catheterization to 100% for indwelling catheters over a duration of 4 days [10].
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