Healthcare-associated urinary tract infections in patients with a urinary catheter: Risk factors, microbiological characteristics and patterns of antibiotic resistance.Authors:
Estíbaliz Jiménez-Alcaide, José Medina-Polo, Lucía García-González, Ana Arrébola-Pajares, Félix Guerrero-Ramos, Santiago Pérez-Cadavid, Raquel Sopeña-Sutil, Raúl Benítez-Sala, Manuel Alonso-Isa, Alba Lara-Isla, Juan Bautista Passas-Martínez y Ángel Tejido-Sánchez.
Arch. Esp. Urol. 2015; 68 (6): 541-550
Vol. 68, Number. 6, Jul/Aug 2015
OBJECTIVE: Catheter-associated urinary tract infections (CAUTIs) are the most common nosocomial acquired infections, with high resistance rates. CAUTIs are a potentially severe complication in hospitalized patients and imply higher costs. Our aim was to analyze the characteristics of CAUTIs in our Urology department.
METHODS: Between November 2011 and October 2013, a prospective observational study was carried out analyzing the incidence of healthcare-associated urinary tract infections in patients admitted to the urology ward with an indwelling urinary catheter. Furthermore, we evaluated associated risks factors and comorbidities such as urinary catheter at the time of admission or urological surgery during the hospitalization. We also presented our results regarding the microbiological characteristics and patterns of resistance to antibiotics in patients with CAUTI admitted in our service.
RESULTS: The incidence of CAUTI was 8.2% (189/2283 patients who had urinary catheter). Mean age was 67.4 ± 14.26 years, 90.2% underwent a surgical procedure (p < 0.001), 14.8% had a urinary stone (p=0.058) and 46% had a urinary catheter before admission (p < 0.001). The most commonly isolated pathogens were Escherichia coli (22.6%), Enterococcus (21.9%) and Pseudomonas aeruginosa (13.9%). E.coli showed resistance rates of 41.9% for quinolones, 33.3% of them produced extended spectrum βeta-lactamase (ESBL). P.aeruginosa showed resistance rates of 42.1% for quinolones and 21.1% for carbapenems.
CONCLUSIONS: Healthcare-associated CAUTI in patients hospitalized in a urology ward are related to risks factors such as having a urinary catheter before admission and undergoing a surgical procedure. Moreover, CAUTIs have higher incidence of pathogens with antibiotic resistances and non-common pathogens such as Enterococcus spp.