Clinical characteristics and outcomes of critically ill COVID-19 patients with CAUTI: a study in Vietnam.

Abstract

Urethral catheterization is commonly required in coronavirus disease 2019 (COVID-19) patients hospitalized in intensive care units (ICUs). However, this increases their vulnerability to nosocomial infections such as catheter-associated urinary tract infections (CAUTIs). Existing studies on nosocomial infections in COVID-19 patients usually report CAUTI prevalence but neglect the clinical differences between CAUTI and non-CAUTI patients. This study aimed to assess clinical features, microbiological characteristics, and outcomes of COVID-19 patients with CAUTI vs non-CAUTI patients in an ICU. We analyzed the clinical data from a retrospective cohort study of 527 critically ill COVID-19 patients who required urethral catheterization at the ICU of Bach Mai hospital in Ho Chi Minh City, Vietnam, from August to October 2021. A total of 69 patients (n = 37 CAUTI vs n = 32 non-CAUTI) were selected for urine culture, and their clinical features, microbiological characteristics, and outcomes were recorded for analysis. COVID-19 patients with CAUTI had a higher mortality rate compared to those without CAUTI (p = 0.02). The length of stay in the ICU was 1.4 times longer for CAUTI patients compared to the non-CAUTI group (p = 0.03). Fungi was the most common microbiological cause of UTI in COVID-19 ICU (91.4%), and Pseudomonas aeruginosa was a significant risk factor of CAUTI. P. aeruginosa, number of antibiotics used, and duration of catheterization had a strong association with the patients' survival time in ICU. This study provides a better understanding of CAUTI in COVID-19 patients, thus facilitating their future treatment.