Abstract
Urinary tract infections (UTI) are very common in all the developed as well as developing countries in which the majority of infections are catheter associated. Catheter associated urinary tract infections (CAUTI) is one of the major causes of hospital acquired infections. The aim of this study is to investigate influential demographic factors responsible for contamination associated with the rate of CAUTI, while taking into account type of urinary catheter used, the most common organisms found, patient diagnosis, age, gender, and comparison with other studies. During the study, 22 uropathogenic species were isolated from the different segments of urinary catheter samples of the patients collected from 12 different hospitals of Amravati city, Maharashtra, India from January 2015 to 2018. Gram negative organisms were the most frequent isolates, with Pseudomonas aeruginosa (16.08%) being the most common followed by Escherichia coli (10%) and Candida albicans accounted for almost 11% of all the uropathogens. It was found that the majority of uropathogens were isolated from the section A (Catheter segment inside the bladder) and section E (Catheter segment connected to drainage tube) of the urinary catheter. The duration of the catheterization plays the major role in the contamination and further infection to continue. It was observed that the female catheterized patients are more prone to the contamination and infection as compared to male catheterized patient. The antibiotic sensitivity pattern indicates that MAR (Multiple Antibiotic Resistance) index was more than 0.2 for almost all the uropathogens tested concluding that there is antibiotic stress on uropathogens and rate of resistance increased rapidly. Also it was found that there was a statistically significant association between the duration of catheterization, type of disease, age of patient and type of catheter with respect to gender.
Highlights
Urinary tract infections (UTIs) are common, recurring diseases that are moderate to life-threatening
The aim of this study is to investigate influential demographic factors responsible for contamination associated with the rate of Catheter associated urinary tract infections (CAUTI), while taking into account type of urinary catheter used, the most common organisms found, patient diagnosis, age, gender, and comparison with other studies
Gram negative organisms were the most frequent isolates, with Pseudomonas aeruginosa (16.08%) being the most common followed by Escherichia coli (10%) and Candida albicans accounted for almost 11% of all the uropathogens
Summary
Urinary tract infections (UTIs) are common, recurring diseases that are moderate to life-threatening. In addition to our growing understanding of the dangerous consequences conferred by the broad spectrum antibiotics use, the persistent emergence of antibiotic resistance gets increasing rapidly and UTI is the major cause of all catheter associated urinary tract infections. Cystitis is classified as “complicated cystitis” in pregnant or immunocompromised patients and patients with functional urinary tract abnormalities, an indwelling catheter or a history of renal transplantation [4]. In approximately 0.34% of cases, pathogens causing cystitis ascend further through the ureters into the kidney, where they cause an infection of the renal pelvis, calices and cortex that leads to the clinical signs and symptoms of pyelonephritis [5]. In patients presenting to the emergency department with sepsis, 27% of all cases can be attributed to a previous urinary isolate, and are termed “urosepsis” [7]. There is an urgent need to develop antibiotic-sparing therapeutics that can break the vicious cycle of rUTI, antibiotic resistance and the interconnection to sepsis
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