Incidence Risk Factors and Drug Resistance Patterns of Bacterial Isolates in Patients with Catheter-associated Urinary Tract Infections.

Abstract

Introduction: Catheter-associated urinary tract infections (CAUTIs) account for 80% of nosocomial UTIs and 40% of hospital-acquired infections, making them the most common healthcare-associated infections globally. Despite the rise of quinolone-resistant Escherichia coli and extended-spectrum β-lactamase-producing gram-negative bacteria, fluoroquinolones remain a common empirical treatment. Understanding antimicrobial resistance (AMR) associated with CAUTIs is critical.

Methods: A prospective observational study was conducted from November 2023 to July 2024 at Deenanath Mangeshkar Hospital, Maharashtra, India. The study included catheterized patients in the intensive care unit (ICU) with a duration of over 48 hours showing UTI symptoms, including fever, suprapubic discomfort, urgency, or dysuria. Among 80 patients (mean age 56.75 ± 23.65 years; 53% male), bacterial isolates, resistance patterns, and risk factors were analyzed.

Results: Catheter-associated UTIs developed in 59 patients (73.75% prevalence; 83.1 per 1,000 catheter days). Patients aged over 60, hospitalized for more than 10 days, or with comorbidities like diabetes (51.3%), hypertension (HTN) (37.5%), or chronic kidney disease (10%) were at higher risk. Escherichia coli and Klebsiella pneumoniae were the most common pathogens (34.14%), with gram-negative bacilli constituting 84.74% of isolates. Candida species, particularly C. tropicalis (34.78%) and C. auris (26%), were also significant.

Conclusion: This study identifies E. coli, K. pneumoniae, and Candida species as major CAUTI pathogens, with substantial multidrug resistance among gram-negative bacteria. Regular AMR surveillance and targeted infection control strategies are essential to combat CAUTI-related challenges and improve clinical outcomes.

How to cite this article: Jha T, Khaparde M, Parkhe TS, Purandare B, Lavate R. Incidence Risk Factors and Drug Resistance Patterns of Bacterial Isolates in Patients with Catheter-associated Urinary Tract Infections. Indian J Crit Care Med 2025;29(4):338-344.