BACTERIOLOGICAL PROFILE OF CATHETER ASSOCIATED URINARY TRACT INFECTION IN MEDICAL INTENSIVE CARE UNIT

Abstract

Background: Urinary tract infection (UTI) is the most common nosocomial infection among which more than 80% are catheter-associated (CAUTI)[1]. As compared to patients in non-critical area, those in intensive care unit have more risk of acquiring CAUTI [2,3]. Objective: This study was conducted to determine the bacteriological prole of catheter associated urinary tract infection in medical intensive care unit (ICU) patients and perform antibiotic susceptibility pattern of the isolated organisms. The risk factors associated with CAUTI was also determined. Methods: A total of 100 patients admitted in medical ICU and put on Foley's catheter were included in the study. They were followed up for the development of symptomatic CAUTI as per CDC guidelines. Urine culture, isolation and identication of organism were done by per standard microbiological methods. Antibiotic susceptibility testing was done by disc diffusion and MIC method following CLSI guidelines. Results: This study identied 26
CAUTI cases with 40 isolated organisms. Most isolates were from Enterobacteriaceae (34.5%) and non-fermenters (32.5%). Pseudomonas aeruginosa was the most common (25%), followed by Klebsiella pneumoniae (17.5%), Enterococcus faecalis (15%), Escherichia coli (15%), and Candida spp. (15%). High resistance was noted among Enterobacteriaceae, with 66.67% ESBL, 22.22% Amp C, 11.11% MBL, and 11.11% carbapenemase production. One methicillin-resistant Staphylococcus aureus was also isolated. Conclusion: The development of CAUTI is frequently observed in critically ill patients, with most cases being attributed to Gram-negative organisms. The rise of antimicrobial resistance is a global concern, with a growing number of multidrug-resistant strains causing CAUTI. To reduce the incidence of drug resistance, the prophylactic use of antibiotics should be avoided.