A Study on Catheter-Associated Urinary Tract Infections in the MedicalICU of a Western Gujarat Tertiary Care Hospital

Abstract

Introduction: CAUTIs are common ICU infections caused by bacterial colonization and biofilm formation oncatheters, leading to increased morbidity and antimicrobial resistance. Escherichia coli, Klebsiella pneumoniae,and Pseudomonas aeruginosa are predominant pathogens. Prolonged catheterization and poor aseptic practicesheighten infection risks. Early catheter removal and strict infection control are key to reducing CAUTI rates inICU patients.Materials and Methods: This hospital-based prospective observational study was conducted in a 15-beddedMedical ICU over one year, enrolling 100 patients requiring Foley’s catheterization. Patients were followedfrom catheter insertion to discharge or death. Inclusion criteria included >48 hours of catheterization and clinicalsigns of infection, while those with pre-existing UTIs or fungal infections were excluded. Urine samples werecollected aseptically and processed using standard microbiological techniques, with antibiotic susceptibilitytesting (AST) conducted per CLSI guidelines. Data analysis was performed using SPSS version 21.1, withstatistical significance set at p<0.05.Results: In our study, 12% of catheterized patients developed CAUTI, with a rate of 8.4 per 1000 urinarycatheter days. The majority of patients were 51–70 years old (36%), with a male predominance (55%).Escherichia coli was the most common pathogen (6%), followed by Enterococcus (4%) and Pseudomonas (3%).CAUTI incidence increased with catheter duration, rising from 2.86% in 1–5 days to 50% beyond 11 days.Antibiotic susceptibility testing showed high efficacy of Nitrofurantoin (100%), Imipenem (91.67%), andColistin (91.67%) against Gram-negative bacteria, while Enterococcus exhibited 100% susceptibility to HighGentamycin and Linezolid.Conclusion: CAUTI remains a significant concern in ICU patients, with prolonged catheterization increasinginfection risk. Strict infection control measures, timely catheter removal, and targeted antibiotic therapy areessential to reducing CAUTI rates and improving patient outcomes.Keywords: CAUTI, ICU infections, Catheter duration, Antibiotic susceptibility.