Comparison Between Non-Catheterized And Catheter Associated Urinary Tract Infections Caused By Extended Spectrum B-Lactamase ProducingEscherichia ColiAndKlebsiella Pneumoniae

Abstract

Catheter associated urinary tract infection's (CAUTI) account for more than 80% of all healthcare associated infections (HAIs) as compared to non-catheterized urinary tract infections.Catheter associated urinary tract infections occur on the third day after insertion of catheter in patients having urinary tract infection (UTI). In long term catheter use, bio-film form along the catheter which increases the risk of antibiotic resistant pathogens. Most common pathogens involved were Escherichia coli and Klebsiella pneumoniae which produce the enzymes Extended Spectrum β-Lactamases (ESBLs).Objective: To compare the frequency of ESBLs in catheterized and non-catheterized UTI infections. . Urine samples were cultured according to WHO protocol and antimicrobial Susceptibility testing was performed by Modified Kirby-Bauer disc diffusion Method. Escherichia coli and Klebsiella pneumoniae were tested for ESBL production by phenotypic confirmatory method of disk diffusion synergy using a disc of amoxicillinclavulonate (30μg) and ceftrixone (30μg), cefotaxime (30μg) and aztreonam (30μg) discs. Results: Out of 300 positive urinary isolates of Escherichia coli and Klebsiella pneumoniae from CAUTI, 65.33% were ESBL producing isolates whereas out of 300 positive urinary isolates of Escherichia coli and Klebsiella pneumoniae from non-catheterized UTI, 47.66% were ESBL producing isolates. The results were highly significant (p < 0.001). Conclusion: Results showed that frequency of ESBLs were higher in catheterized patients as compared to non-catheterized patients. This is suggestive of a need for regular screening and surveillance for ESBL producing organisms. Patients infected with these organisms should be nursed with contact precautions to avoid the spread of nosocomial infection.100% after 30 days [4]. Bacterial colonies form into the epithelial cells of the urinary tract which are responsible for the infection [5]. The infection that occurs with an indwelling Foley's urinary catheter within 48 hours is a catheter-associated urinary tract infection [6]. Indwelling Foley's urinary catheter enables emptying of the bladder. Urinary catheterization is categorized as short term that is in situ less than 28 days or long term is in situ more than 28 days [7]. The presence of bacteria in urine is known as bacteriuria which is either asymptomatic (CA-ASB) or symptomatic bacteriuria. Asymptomatic bacteriuria is usually present in CAUTI [8]. Patients with urinary tract infections have symptoms of fever, urinary urgency, lower abdominal pain, dysuria, pyuria, and leukocytes in urine [9]. The presence of bacteria with a count of 10 5 CFUs per ml is an indication of urinary tract infection [10]. The level of bacteria in urine increases from 10 5 to 10 8 CFU per ml within 24 to 48 hours if antimicrobial therapy is not given to the patient [11]. Bio-film formation along the catheter reflects the presence of organisms that increase resistance to the host immune response and to antibiotics. Bio-film forms when a catheter was inserted greater t...

Assessment of Perceptions and Practices of the Nurses to Prevent Indwelling Catheter Associated Infection; Jinnah Hospital Lahore, Pakistan

“…(Ashraf et al, 2015). Another study in Pakistan depicts 31 positive catheters tips out of sixty patients.…”

“…(Centers for Disease Control & Prevention, 2015).A study conducted by Ashraf, Iram, Rasheed & Shukat in 2015 on catheter associated urinary tract infection concludes that as compared to non-catheterize patients, catheter associated infection account for more than 80% of all health care associated infections. (Ashraf et al, 2015). Another study in Pakistan depicts 31 positive catheters tips out of sixty patients.…”

Bacterial profile, antimicrobial susceptibility pattern and associated factors of community and hospital acquired urinary tract infection at Dessie referral hospital, Dessie, Northeast Ethiopia

“…Hospital acquired urinary tract (HAUTI) infections are mostly health care related infection and stand out from all hospital acquired infections, because these are the ones that occur more frequently and are commonly related to the use of a medical device such as catheterization. Hospitalized patients who acquired UTI have more comorbidities, recurrent, and have previously received antibiotics more often than patients with CAUTI (10,12,13).…”

“…Studies reveal that 79.3% of UTI can be prevented, if catheterization was not performed in hospitals (16). Multiple risk factors can affect the occurrence of urinary tract infections, these includes age ,sex, catherization and hospitalization, previous exposure of the antibiotics, recurrent UTI, duration of catheterization and care of catheter are included (12,(17)(18)(19)(20).…”

Study the effect of different temperatures on the biofilm production in Proteus mirabilis isolated from urinary tract infection patients

“…The formation of the biofilm is dangerous because its danger lies in its resistance to most antibiotics, due to the presence of several mechanisms that enable it to reduce or inhibit these antigens and also enhances the resistance of bacteria to the immune response (Ashraf et al, 2015).…”