Magnitude and Factors Associated with Catheter Associated Urinary Tract Infection, and Antimicrobial Susceptibility Profile at Hawassa, Sidama Regional State, Ethiopia: A prospective Cross-sectional Study

Abstract

Introduction: The use of urinary catheter benefit patients who are unable to urinate for various medical reasons. Despite its use, a urinary catheter during its application may introduce bacteria to the urinary tract and result in Urinary tract infection (UTI). Even though  the burden of catheter-associated UTI is expected to be high in resource-limited countries, there is limited data. The aim of this study was  to determine the magnitude of culture- confirmed catheter-associated urinary tract infection (CAUTI), associated factors, and  antimicrobial susceptibility profiles of bacteria.
 Methods: This prospective cross-sectional study was conducted at Hawassa University Comprehensive Specialized Hospital (HUCSH),  Sidama region, from May-August 2022. One hundred forty-nine catheterized patients at HUCSH were included. Socio-demographic,  clinical, and laboratory data were collected using structured questionnaire. Urine specimens were cultured on blood and MacConkey  agar. Culture-confirmed catheter-associated urinary tract infection was established if >1 X 105 colonies of bacteria per milliliters of urine  was detected. The disc diffusion method was used for antimicrobial susceptibility testing. For data analysis, SPSS version 26 was used.  Factors associated with culture-confirmed CAUTI were assessed using binary logistic regression.
 Results: The magnitude of culture  confirmed CAUTI was 30.2% (n=45; 95% CI=22.8−37.6). The most common bacterial isolates were Escherichia coli (n=12; 26.7%), followed  by Klebsiella species (n=10; 22.2%), and Staphylococcus aureus (n=6; 13.3%). Duration of catheterization (AOR=9.6, 95% CI=3.8−24.2) and  comorbidities (AOR=4.1, 95% CI=1.7−9.8) were significantly associated with culture-confirmed CAUTI. Most Gram- negative bacteria were  resistant to commonly prescribed antimicrobial agents.
 Conclusions: The magnitude of culture-confirmed CAUTI at HUCSH was high. E. coli was the leading bacteria and most of them were resistant to various types of antimicrobial agents. Duration of catheterization and  comorbidities were significantly associated with culture- confirmed CAUTI.