PREVALENCE AND ANTIMICROBIAL SUSCEPTIBILITY PATTERN OF GRAM NEGATIVE BACTERIA ISOLATES IN CATHETER ASSOCIATED URINARY TRACT INFECTION IN TERTIARY CARE HOSPITAL
Main Article Content
Keywords
Catheter-associated urinary tract infection (CAUTI), Gram-negative bacteria, Escherichia coli, Antimicrobial susceptibility, Hospital-acquired infections, Catheterization, Tertiary care hospital
Abstract
Introduction: Urinary tract infections (UTIs) are a leading healthcare-associated infection, often linked to urinary catheter use, with a daily 3%-7% increased risk of catheter-associated UTIs (CAUTIs). CAUTIs cause significant complications; prolonged hospital stays, and increased mortality, with 13,000 deaths annually. This study examines the bacteriological profile and antimicrobial resistance patterns of CAUTIs in a tertiary care hospital.
Material and Methods: A cross-sectional study done at a tertiary hospital included 200 catheterized patients over six month. Urine samples were collected aseptically following CDC guidelines, excluding patients with prior UTIs, suprapubic catheters, or pre-admission catheterization. Demographic and clinical data were recorded. Suspected CAUTI samples were cultured, with significant growth defined as ≥10⁵ CFU/ml. Isolates were identified, and antimicrobial susceptibility tested using CLSI-guided Kirby-Bauer disc diffusion.
Results: Among 200 catheterized patients, 25 (12.5%) developed CAUTI, with females (68%) affected more than males (32%). The highest infection rate occurred in the 41–60 years age group (39.5%), followed by 21–40 years (33%). A total of 25 gram-negative bacteria were isolated, predominantly Escherichia coli (48%), followed by Klebsiella spp. (36%) and Pseudomonas aeruginosa (16%).
Conclusion: The study highlights that catheter-associated urinary tract infections (CAUTIs) are more prevalent in females and middle-aged individuals, with Escherichia coli being the most common causative organism. The findings emphasize the importance of monitoring antimicrobial susceptibility to guide effective treatment strategies and reduce the burden of CAUTIs in hospitalized patients.
References
2. McGuckin M. The patient survival guide: 8 simple solutions to prevent hospital and healthcare-associated infections. New York, NY: Demos Medical Publishing; 2012.
3. Lo E, Nicolle LE, Coffin SE, Gould C, Maragakis LL, Meddings J, et al. Strategies to prevent catheterassociated urinary tract infections in acute care hospitals: 2014 update. Infection Control and Hospital Epidemiology 2014; 35:464-79.
4. Scott R. The Direct Medical Costs of Healthcare-Associated Infections in U.S. Hospitals and the Benefits of Prevention, 2009. Division of Healthcare Quality Promotion, National Center for Preparedness, Detection, and Control of Infectious Diseases, Coordinating Center for Infectious Diseases, Centers for Disease Control and Prevention, February 2009.
5. Klevens, R., Edward, J., et al. Estimating Healthcare-associated Infections and Deaths in U.S. Hospitals. Public Health Reports. 2007;122: 160-166.
6. Patel R, Chauhan AP, Pandya H et al. Microbiological aspects of catheter associated urinary tract (CAUTI) infections in tertiary care hospital: A prospective cross-sectional study. IP Int J Med Microbiol Trop Dis. 2024;10(2):145-150.
7. Parihar S, Sharma R, Kinimi SV et al. An Observational Study from Northern India to Evaluate Catheter-associated Urinary Tract Infection in Medical Intensive Care Unit at a Tertiary Care Center. Indian journal of critical care medicine: peer-reviewed, official publication of Indian Society of Critical Care Medicine. 2023 Sep;27(9):642.
8. Sandhu R, Sayal P, Jakkhar R et al. Catheterization-associated urinary tract infections: Epidemiology and incidence from tertiary care hospital in Haryana. Journal of Health Research and Reviews. 2018 Sep 1;5(3):135-41.
9. Sushitha TS, Suseela KV. Catheter Associated Urinary Tract Infections: A Cross sectional Study from a Tertiary Care Center in Kerala, India. Natl. J. Lab. Med. 2022;11 :9-12.
10. Mohapatra S, Panigrahy R, Tak V et al. Prevalence and resistance pattern of uropathogens from community settings of different regions: an experience from India. Access Microbiology. 2022 Feb 9;4(2):000321.
11. Bagali S, Mantur PG. Bacteriological Profile of Catheter Associated Urinary Tract Infection and its Antimicrobial Susceptibility Pattern in a Tertiary Care Hospital.
12. Patel PK, Pattani MH. A study on prevalence of bacterial isolates causing urinary tract infection at tertiary care hospital, Rajkot, Gujarat, India. Trop J Pathol Microbiol. 2019;5(7):454-460.
13. Sharma AK, Kumari S, Prasad A et al. Analysis of Catheter Associated Urinary Tract Infections (CAUTI) and Antibiotic Susceptibility Pattern of Uropathogens Causing CAUTI at Tertiary Care Hospital. European Journal of Molecular & Clinical Medicine. 2019;6(1):ISSN 2515-8260
14. Garg N, Shukla I, Rizvi M et al. Microbiological Profile and Antibiotic Sensitivity Pattern of Bacterial Isolates Causing Urinary Tract Infection in Intensive Care Unit Patients in a Tertiary Care Hospital in Aligarh Region, India . J.Curr.Microbiol.App.Sci. 2015;1:163-172
15. Panjwani DM, Lakhani SJ, Mehta SJ et al. A comprehensive study of microbiological profile, risk factors and antibiotic sensitivity pattern of catheter associated urinary tract infection in a teaching hospital of Gujarat. Journal of Applied Biology & Biotechnology. 2021 Sep 1;9(05):83-8.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Krishna Kant Sharma
Ph.D. Research Scholar, Department of Microbiology, Faculty of Medicine, Pacific Medical University, Udaipur
Ritu Bhatnagar
Professor and Head, Department of Microbiology, Pacific Medical College and Hospital, Pacific Medical University Udaipur, Rajasthan, India