Catheter associated urinary tract infection offending pathogens, antimicrobial sensitivity, and complications

Abstract

Background: Catheter-associated urinary tract infection (CAUTI) is a source of morbidity in patients on indwelling urinary catheters. Patients in both outpatient and inpatient general wards can be on indwelling urinary catheters at one time or the other due to various underlying pathologies. These indwelling urinary catheters can attract microorganisms into the urinary tract causing CAUTI. The aim is to determine the offending pathogens, antimicrobial sensitivity, and complications in CAUTI. Patients and Methods: This was a prospective interventional study involving catheterized patients without prior urinary tract infection. The catheters were inserted due to various underlying pathologies either on an outpatient basis or on admission in the general ward. On suspicion of infection by the presence of any of these, cloudy urine, pericatheter pain, suprapubic pain, fever, chills or hematuria, and urine samples were aseptically collected by the laboratory scientist for culture and sensitivity. Any significant bacteriuria either asymptomatic or symptomatic was documented, and the offending pathogens also identified. Antimicrobial sensitivity patterns were recorded, and any complications noted in the patients were recorded. Results: A total of 460 patients, 376 (81.7%) males and 84 (18.3%) females were recruited into the study. The prostatic disease was the most common pathology necessitating urinary catheterization, accounting for 59.5% of all the cases. There were 100% recorded cases of CAUTI in the study. Escherichia coli was the most common organism isolated 45.2%. There was asymptomatic bacteriuria in 81% of the patients, while in 19%, it was symptomatic. There was multidrug resistance to the commonly used antimicrobials. Conclusions: CAUTI still poses enormous challenges to both the outpatients and general inpatients. To minimize CAUTI, indiscriminate use of urinary catheters should be discouraged and urinary catheters should be removed immediately; they serve the purpose for which they were inserted.