Abstract
The important risk factor for the development of CAUTI, especially in the intensive care units, is the presence, method and length of Duration of urinary catheterization. The other potential significant risk factors are gender, age, uncontrolled diabetes and long hospital stay. There have been no studies on Tribal patients describing the factors (Demographic as well as Risk factors) which influence the deviation in microbiological pattern of CAUTI in of the MICU, from the patients of other area studied till now. This prospective study was conducted over Tribal patients aged ≥ 18 years who developed features of symptomatic urinary tract infection following an indwelling urinary Foley’s catheter more than 48 hours, in the Medical Intensive Care Unit. Geographical and Clinical data were collected. The CAUTI rate in 33 Tribal patients was 19.2 per 1000 device days with an incidence of 17.3% in the MICU. The microbiological trend was Staphylococcus aureus 12 (26.0%), E. coli 11 (23.9%), Candida albicans 9 (19.5%), Klebsiella pneumoniae 5 (10.8%), CONS 3 (6.5%), Streptococcus pneumoniae 3(6.0%), Pseudomonas aeruginosa 2 (4.3%) and Acinetobacter baumannii 1 (2.1%). Staphylococcus aureus was the common cause of CAUTI in low and medium socioeconomic tribal patients of more than 20 to 40 years of age, as compared to E. coli in Nontribal Patients. E.coli was found in the dominated female patients and in age upto 20 years and more than 40to 60 years old patients and Klebsiella pneumonae in above 60 years age. High status group with Acinetobactor baumannii. Candida albicans was associated with use of urinary catheter less than 7 days. Length of ICU stay more than 14 days was associated with E. coli and Staphylococcus aureus in equally proportionately. CONS 2(50%) was found in type-2 Diabetes mellitus and Staphylococcus aureus 7 (53.8 %) with Sickle cell anemia in Tribal patients. Our analysis precisely of this Tribal patients, brings several important and unique findings, which will not only aid in the development of some new or update guidelines but also encourage the researcher to do more study, for the prevention of CAUTI in the MICU of Tribal tertiary care centre.
Highlights
Urinary tract infection (UTI) is an infection in any part of the urinary system, including kidney, ureter, bladder, or urethra
Length of intensive care units (ICUs) stay was an another risk factor to develop Catheter associated urinary tract infections (CAUTI) in our study, according to which 22(66.6%) patients stayed for 7-14 days,[8] (24.4%) for less than 7 days and 3(9.0%) stayed for more than 14 days
This microbiological trend was different in our study, where Staphylococcus aureus 12 (26.0%)was first followed by E. coli 11 (23.9%), Candida albicans 9 (19.5%), Klebsiella pneumoniae 5 (10.8%), CONS 3 (6.5%), Streptococcus pneumoniae 3 (6.0%), Pseudomonas aeruginosa 2 (4.3%) and Acinetobacter baumannii 1 (2.1%) in order of frequency
Summary
Urinary tract infection (UTI) is an infection in any part of the urinary system, including kidney, ureter, bladder, or urethra. The other risk factors associated with the cause of CAUTI are female gender, poor nutrition, severity of illness, and immuno compromised status[8,9]. It is associated with many complications leading to increase morbidities and mortalities in the ICUs. It is associated with many complications leading to increase morbidities and mortalities in the ICUs Even if it is the most preventable health care associated infection (HAI), the management of CAUTI is still a challenge. In CAUTI the incidence of infection is Escherichia coli in 21.4%, Candida spp in 21.0%, Enterococcus spp in 14.9% Pseudomonas in 10.0%, Klebsiella in 7.7% and remaining part with other organisms[6,9]
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