Microbiological profile of catheter associated urinary tract infection in ICUs of a tertiary care hospital Bhubaneswar, Odisha, India

Abstract

Among nosocomial infections catheter associated urinary infection (CA-UTI) is one of the most common infection. Uro- pathogens isolated from CAUTI were more multi-drug resistant than from community acquired urinary tract infection (UTI).To isolate micro-organisms responsible for CA-UTI in ICUs, to find out antibiotic sensitivity pattern of the isolates and to know the Impact of CAUTI care bundle on reducing CAUTI rate.A retrospective study was conducted from September 2017 to August 2018, urine samples were collected from 300 catheerised patients which were processed microbiologically and antimicrobial sensitivity test was performed.Out of 300 catheterised paients , 76 patients developed CAUTI. So the incidence rate of CAUTI is 21.7%. A sum total of 38,067 catheter days were obtained in the study period from the month of September 2017 to August 2018. CAUTI rate was found to be 1.9 per 1000 catheter days over a period of 1 yearOut of 76 total isolates 56 were Gram negative and 20 were Gram positive bacteria. Gram negative bacteria included Escherichia coli 19(25%), followed by Klebsiella 14(19%), Proteus8 (11%) Pseudomomas 6(8%), Acinetobacter 4(8%). Among gram positive Enterococcus species is 17(22%) followed by staphylococcus spp.03 (4%). Enterobacteriaceae showed high resistant to commonly used antimicrobials like Gentamycin, Ceftriaxone, Ofloxacin, Ciprofloxacin but were highly sensitive to Amikacin, ceftazidime, pipercillin Tazobactum, Imepenem, Meropenem.Enterococcus and staphylococcus were sensitive to Tigecyclin , Vancomycin, Teicoplanin and linezolid.The most common organism responsible for CAUTI is Escherichia coli followed by Klebsiella spp. and Enerococcus spp. Members of enterobacteriaceae are highly sensitive to Amikacin, ceftazidime, pipercillin Tazobactum, Imepenem, Meropenem. Enterococcus and staphylococcus are sensitive to Tigecyclin, Vancomycin, Teicoplanin and linezolid. Strict insertion and maintainance CAUTI care bundle reduces CAUTI rate. Prevention of infections attributable to these devices should be an important goal of health-care infection prevention