Catheterization-associated urinary tract infections: Epidemiology and incidence from tertiary care hospital in Haryana

Background: Urinary tract infections (UTIs) attributed to the use of an indwelling catheter is one of the most common infections acquired by patients in health-care facilities. This infection is associated with varied microbiological etiology. This along with existing underlying condition increases hospitalization, medication, morbidity, and also adds to the financial burden. Aims and Objectives: The aim of the study was to provide a baseline information in the context of incidence of catheter-associated UTI (CAUTI), to identify the associated microbial, and to determine their susceptibility pattern to commonly used antimicrobial agents for prophylactic and empiric therapy in this group of patients. Materials and Methods: This prospective study was done on nonrepetitive urine samples from catheterized patients. Semi-quantitative bacterial culture was performed, and isolates were identified by standard biochemical tests. Antimicrobial sensitivity tests were carried out by disc diffusion technique using Mueller-Hinton Agar as recommended by Clinical Laboratory Standard Institute. Results: Significant bacteriuria was observed among 17/161 (10.55%) urine samples. Among bacterial isolates, Gram-negative bacilli predominates. Escherichia coli 7/17 (41.17%) being the most common isolate. The incidence of UTI/1000 catheter days and urinary catheter utilization ratio observed in our study was 4.41 and 18.05, 0.673 and 0.066 for intensive care unit and wards, respectively. Conclusion: Burden of CAUTIs is vast with regards to incidence, patient outcomes, cost, reimbursement, and suffering. Our study underscores the pressing need for the development of antimicrobial urinary catheters and also we strove to minimize the effect of exogenous factors on the incidences of CAUTI and regarding the development of protocols and checklists on the insertion and management of indwelling urinary catheters based on the UTI prevention guideline.