Microbiological profile, comorbidity, incidence and rate analysis of catheter associated urinary tract infections in adult intensive care

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Original Article

Author Details : Arunagiri Ramesh, Anand B Janagond, Sundaramurthy Raja, Sorakka Pandurangan Gobinathan, Jhansi Charl

Volume : 5, Issue : 1, Year : 2018

Article Page : 38-43

https://doi.org/10.18231/2394-5478.2018.0007

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Abstract

Introduction: Catheter-associated urinary tract infections (CAUTI) being the commonest hospital-acquired infection (HAI) [40%], its burden, aetiology along with antibiotic susceptibility is essential to implement and monitor an effective infection control program.
Aims: To assess the incidence and rate of CAUTI in a tertiary care hospital and to identify the common organisms and their antibiotic sensitivity pattern.
Settings and Design: Prospective hospital based observational study was carried out in a tertiary care hospital in South Tamilnadu for a period of 2 months (June 2016 to July 2016) after obtaining the Institutional Ethics committee approval.
Materials and Methods: Total of 100 catheterized adult ICU patients were observed for signs of UTI on a daily basis. On clinical suspicion of UTI, urine sample was analysed microbiologically. CAUTI among various gender and age groups; pathogenic isolates, antibiotic sensitivity pattern and associated co-morbid conditions were expressed as percentages
Results: Incidence of CAUTI was 16/100 catheterization. Device utilization ratio was 0.72. CAUTI rate was 36.2/1000 catheter days. CAUTI was commonly seen among patients with >80 years, females with altered sensorium. Diabetes mellitus (35.7%) was the most common comorbid condition followed by TB (25%). Risk of CAUTI after 3-5 days of catheterization was 11.7% and proportionately increased with prolonged catheterization (100% if >20 days). Escherichia coli (37.5%) followed by Candida Spp. (25%) were common pathogens among 3-5days of catheterization. Pseudomonas Spp. was the commonest isolate after one week of catheterization. Imipenem, colistin resistance was highest among pseudomonas.
Conclusions: CAUTI rate was higher than the benchmark set by NHSN (0-4). Appropriate health education, strict infection control practices, appropriate antibiotic policy, proper guided bundle care of catheter are need of the hour to prevent the CAUTI. 

Keywords: Adult ICU, CAUTI, Comorbidity analysis, Incidence, Microbiological Profile.
Key Messages: Incidence of CAUTI was 16 per 100 catheterization and the CAUTI rate was 36.2 per 1000 catheter days which was higher to the benchmark of NHSN (0-4). Risk of CAUTI proportionately increased with prolonged catheterization from 11.7% after 3-5 days to 100% after 20 days. Escherichia coli (37.5%) followed by Candida (25%) were common pathogens among 3-5days of catheterization. Pseudomonas was the common isolate after one week of catheterization.

How to cite : Ramesh A, Janagond A B, Raja S, Gobinathan S P, Charl J, Microbiological profile, comorbidity, incidence and rate analysis of catheter associated urinary tract infections in adult intensive care. Indian J Microbiol Res 2018;5(1):38-43

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