Catheter Associated Urinary Tract Infections: A Cross-sectional Study from a Tertiary Care Centre in Kerala, India
Introduction: Catheter Associated Urinary Tract Infections (CAUTIs) are the commonest nosocomial infection and may lead to serious medical complications. An early detection and appropriate antimicrobial therapy based on antimicrobial susceptibility testing together with infection control practic...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Pvt. Ltd.
2022-04-01
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| Series: | National Journal of Laboratory Medicine |
| Subjects: | |
| Online Access: | https://www.njlm.net/articles/PDF/2605/50755_CE[Ra1]_F(SHU)_PF1(AG_SHU)_PFA(SHU)_PB(AG_SHU)_PN(SHU).pdf |
| Summary: | Introduction: Catheter Associated Urinary Tract Infections (CAUTIs)
are the commonest nosocomial infection and may lead to serious
medical complications. An early detection and appropriate
antimicrobial therapy based on antimicrobial susceptibility
testing together with infection control practices play a key role in
management of CAUTI.
Aim: To identify the aetiological agents causing CAUTI and to
understand the antimicrobial susceptibility pattern of the isolates.
Materials and Methods: A prospective cross-sectional study was
conducted in the Department of Microbiology of a tertiary care
centre in Kerala, India for the duration of six months from JanuaryJune 2014. Urine samples were collected from patients with urinary
catheters in situ for more than three days, admitted in Intensive
Care Unit (ICU) and wards. Urine samples were subjected to wet
mount, culture and susceptibility testing. Responsible pathogens
and their antimicrobial susceptibility pattern were obtained by
using Vitek 2 automated system based on Clinical and Laboratory
Standards Institute (CLSI) standards. Data was analysed using the
International Business Machines Statistical Package for the Social
Sciences (IBM SPSS) version 27.0. Descriptive analysis was used.
Results: Among 150 catheterised patients included, 36 cases
(24%) developed CAUTI. The overall rate of CAUTI was 7.03
per 1000 catheter days in present study. The gram negative
bacilli were the major isolates comprising Enterobacteriaceae
32 (87.5%) and Non fermenters 4 (12.5%). Escherichia coli
was the predominant 19 (53%) organism followed by Klebsiella
pneumoniae, Pseudomaonas aeruginosa, Enterococcus faecalis.
Extended Spectrum Beta Lactamase (ESBL) producing gram
negative bacteria 19 (67.8%) were isolated. The isolates in
CAUTI were found to be susceptible to cefoperazone sulbactam
combination 21 (65.6%), amikacin 22 (68.7%), piperacillin+
tazobactam 24 (75%), nitrofurantoin 27 (84%), imipenem 27 (84%)
and tigecycline 27 (96.4%). All were susceptible to colistin. The
gram positive isolates were susceptible to nitrofurantoin 3 (75%),
vancomycin and linezolid (both 100%).
Conclusion: CAUTI is a preventable Hospital Acquired Infection
(HAI) seen worldwide, but the incidence can be lowered by
reducing the catheter procedures, the duration of catheterisation
and taking aseptic precautions and by appropriate prophylactic
antibiotics. |
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| ISSN: | 2277-8551 2455-6882 |