CATHETER-ASSOCIATED URINARY TRACT INFECTIONS AND ANTIMICROBIAL SENSITIVITY PATTERN OF ORGANISMS IN INTENSIVE CARE UNIT PATIENTS AT A TERTIARY CARE HOSPITAL.

Abstract

Introduction: Catheter-associated urinary tract infections (CAUTIs) represent one of the leading types of hospital-acquired infections (HAIs) worldwide.^[1] Extended hospital stays, the use of invasive medical devices such as indwelling urinary catheters, and inappropriate or excessive administration of antimicrobial drugs are widely recognized as key contributors to the rising incidence of HAIs.^[2] Among critically ill patients with urinary catheters, infections including pyelonephritis, urethritis, cystitis, and prostatitis are frequently observed and pose significant clinical challenges. Gram-negative organisms are predominantly responsible for these infections in intensive care unit (ICU) settings.^[3]

Method: This investigation was designed as a cross-sectional, hospital-based study carried out in the Department of Microbiology at a tertiary care teaching hospital. Urine samples were collected from catheterized patients and cultured on CLED agar. Isolated colonies were identified and antibacterial susceptibility testing was performed by an automated method i.e. Vitek Compact.

Result: This investigation was conducted to assess the prevalence of CAUTI, identify the causative microorganisms, evaluate their antimicrobial susceptibility profiles, and analyse associated risk factors to support evidence-based prevention strategies. During the study period, 350 patients were admitted to the ICU, and healthcare-associated infections were documented in 105 cases. Of these, 35 patients were diagnosed specifically with CAUTI. Microbiological analysis revealed that Klebsiella pneumoniae (28.6%) was the most frequently isolated pathogen, followed by Pseudomonas aeruginosa (20%), Proteus mirabilis (14.3%), Acinetobacter baumannii (11.4%), Enterococcus faecalis (5.7%), and Staphylococcus aureus (5.7%). These findings highlight the predominance of Gram-negative bacteria in CAUTI cases within the ICU population.

Conclusion: Gram-negative bacteria predominated, with a high frequency of multidrug-resistant strains and significant beta-lactamase production.

These findings have important clinical implications. Continuous surveillance of local antibiogram patterns, strict adherence to catheter care protocols, early catheter removal, and implementation of robust antibiotic stewardship programs are essential to reduce CAUTI rates and combat antimicrobial resistance. The data generated may assist healthcare institutions in developing targeted infection prevention strategies and optimizing empirical treatment guidelines at a national level.