Identification and susceptibility pattern of Gram negative bacterial isolates of Catheter Associated Urinary Tract Infections (CAUTI) in a tertiary care institute

Catheter associated urinary tract infection (CAUTI) is the most common health care associated infection worldwide. Multiple factors (type of catheter, insertion procedure, duration of catheter, handling of catheter and primary disease of the patient etc.) are responsible for the CAUTI.

This prospective study was conducted in a tertiary care teaching hospital over a period of one and half year from January 2012 to June 2013. CDC's CAUTI case definitions were used to label a case as CAUTI. Only culture proven cases, out of clinically suspected was included in the study for evaluation.

Overall rate of CAUTI was 7.53 per 1000 device days. Out of 136 cultures proven cases of CAUTI 129 showed growths of Gram negative bacteria, among them E. coli (62.01%) was the leading isolate followed by Klebsiella pneumoniae (12.40%) and Pseudomonas aeruginosa (11.62%). Among common Gram negative bacterial isolates E. coli exhibited (98.75%) resistance to ampicillin, (96.25%) to amoxycillin+clavulanic and (96%) to cefuroxime followed by (82.5%) to ciprofloxacin and (47.5% & 22.5%) to gentamicin and amikacin respectively. Three isolates were resistant to imipenem. Klebsiella pneumoniae exhibited (100%) resistance to ampicillin, amoxycillin+clavulanic, piperacillin, and cefuroxime, (93%.75) to ciprofloxacin followed by (81.25% & 68.75%) to gentamicin and amikacin respectively. None of the isolates of Klebsiella pneumoniae were resistant to imipenem.

Proper insertion, handling, lesser duration of Urinary Catheter and continuous display and analysis of microbiological data of the cases of CAUTI will help in curbing down the incidences of CAUTI.