COMPREHENSIVE ANALYSIS OF CATHETER-ASSOCIATED URINARY TRACT INFECTIONS: RISK FACTORS, MICROBIAL DYNAMICS, AND ANTIMICROBIAL CHALLENGES IN A TERTIARY CARE SETTING
DOI:
https://doi.org/10.22159/ajpcr.2024.v17i3.50465Keywords:
UTI, CAUTI, CAABU, CATHETER, SEPSIS, asymptomatic bacteriuria, biofilmAbstract
Objective: Our objectives included investigating CAUTI incidence, exploring factors contributing to UTI risk, examining the correlation between bacteriuria and symptomatic CAUTI, and recording microbiological profiles and antibiotic sensitivities for insights into microbial dynamics and treatment strategies.
Indwelling urinary catheters are frequently employed in medical procedures; yet, they pose a considerable risk, with catheter-associated urinary tract infections (CAUTIs) being a global healthcare challenge. CAUTIs account for 30–40% of nosocomial infections, contributing to heightened morbidity and mortality.
Method: We aimed to assess patient and catheter-related factors influencing urinary tract infections (UTIs) in 105 catheterized patients.
Results: Among the studied cohort, with an average age of 47.73 years, various catheter sizes were employed, and post-operative catheterization was the predominant indication. Microbial presence in urine samples was detected in 31.4% of cases, with a 21% prevalence of symptomatic UTIs. Diabetes mellitus showed a significant association with increased UTI occurrences (p=0.019). Notably, catheterization outside the operating theater (OT) and prolonged catheterization duration were significantly associated with increased infection rates (p=0.000 and p=0.003, respectively). Despite antibiotic treatment, Escherichia coli remained the most prevalent organism causing infection (17.1%), and antibiotic resistance trends were observed, highlighting the challenges of antimicrobial stewardship.
Conclusion: The study emphasizes the importance of preventive measures, such as reducing catheterization duration and meticulous diabetes management, to mitigate the burden of CAUTIs. In conclusion, this study provides valuable insights into the prevalence, risk factors, and microbial dynamics of CAUTIs, urging a shift toward proactive prevention strategies and judicious antibiotic use to enhance patient outcomes and alleviate the strain on health-care resources.
Downloads
References
Available from: https://www.cdc.gov/nhsn/pdfs/ pscmanual/7psccauticurrent.pdf
Nicolle LE. Catheter associated urinary tract infections. Antimicrob Resist Infect Control 2014;3:23.
Magill SS, O’Leary E, Janelle SJ, Thompson DL, Dumyati G, Nadle J, et al. Changes in prevalence of health care associated infection in the U.S. hospitals. N Engl J Med 2018;379:1732-44.
Nicolle LE, Bradley S, Colgan R, Rice JC, Schaeffer A, Hooton TM. Infectious diseases society of America guidelines for the diagnosis and treatment of asymptomatic bacteriuria in adults. Clin Infect Dis 2005;40:643-54.
Avalos Vizcarra I, Hosseini V, Kollmannsberger P, Meier S, Weber SS, Arnoldini M, et al. How type 1 fimbriae help Escherichia coli to evade extracellular antibiotics. Sci Rep 2016;6:18109. doi: 10.1038/ srep18109
Michael CA, Dominey-Howes D, Labbate M. The antimicrobial resistance crisis: Causes, consequences, and management. Front Public Health 2014;2:145. doi:10.3389/fpubh.2014.00145
Ventola CL. The antibiotic resistance crisis: Part 1: Causes and threats. P T 2015;40:277-83.
Feneley RC, Hopley IB, Wells PN. Urinary catheters: History, current status, adverse events and research agenda. J Med Eng Technol 2015;39:459-70.
Domingo KB, Mendoza MT, Torres TT. Catheter-related Urinary tract infections: Incidence, Risk factors and microbiologic profile. Phil J Microbiol Infect Dis 1999;28:133-8.
Danchaivijitr S, Dhiraputra C, Cherdrungsi R, Jintanothaitavorn D, Srihapol N. Catheter-associated urinary tract infection. J Med Assoc Thai 2005;88:26-30.
Cope M, Cevallos ME, Cadle RM, Darouiche RO, Musher DM, Trautner BW. Inappropriate treatment of catheter-associated asymptomatic bacteriuria in a tertiary care hospital. Clin Infect Dis 2009;48:1182-8. doi: 10.1086/597403. PMID: 19292664
Platt R, Polk BF, Murdock B, Rosner B. Risk factors for nosocomial urinary tract infection. Am J Epidemiol 1986;124:977-85.
Shapiro M, Simchen E, Izraeli S, Sacks TG. A multivariate analysis of risk factors for acquiring bacteruria in patients with indwelling urinary catheters for longer than 24 hours. Infect Control 1984;5:525-532.
Johnson JR, Roberts PL, Olsen RJ, Moyer KA, Stamm WE. Prevention of catheter-associated urinary tract infection with a silver oxide-coated urinary catheter: Clinical and microbiologic correlates. J Infect Dis 1990;162:1145-50.
Bhatia N, Daga MK, Garg S, Prakash SK. Urinary catheterization in medical wards. J Glob Infect Dis 2010;2:83-90.
Gillen JR, Isbell JM, Michaels AD, Lau CL, Sawyer RG. Risk factors for urinary tract infections in cardiac surgical patients. Surg Infect 2015;16:504-8.
Maki DG, Tambyah PA. Engineering out the risk for infection with urinary catheters. Emerg Infect Dis 2001;7:342-7.
Tenke P, Köves B, Nagy K, Hultgren SJ, Mendling W, Wullt B, et al. Update on biofilm infections in the urinary tract. World J Urol 2012;30:51-7.
Published
How to Cite
Issue
Section
Copyright (c) 2023 DR. RAVIKUMAR JADHAV, Dr. THAKAPPA N.G., DR. RAVIRAJ RAYKAR, DR.MANJUPRASAD G.B, DR. SAMPATHKUMAR , Shivaratna Mahadik, DR.JAIDEEP RATKAL
This work is licensed under a Creative Commons Attribution 4.0 International License.
The publication is licensed under CC By and is open access. Copyright is with author and allowed to retain publishing rights without restrictions.
