Infection surveillance analysis of catheter associated urinary tract infections in obstetrics and gynecology department of a tertiary care hospital of Central India

Abstract

INTRODUCTIONThe prevalence of catheter associated urinary tract infections (CAUTIs) in the catheterized patients in acute care settings (catheter used for <7 days) is 3%-7%, in patients who require a urinary catheter for >7 days, it is up to 25% and it approaches 100% after 30 days. 1, 2About 17% of the healthcare associated bacteremia are from urinary sources, with an associated mortality of approximately 10%. 2The rootstock of the pathogens which cause CAUTIs are either endogenous, i.e., via meatal, rectal or vaginal colonization or exogenous, i.e., via the contaminated hands of the healthcare personnel or via contaminated equipment. Microbial pathogens can enter the urinary tract either by the extra-luminal route, along the outside of the catheter, or by the intra-luminal route along the internal lumen of the catheter from the contaminated collection bag or from the catheter drainage tube junction.As the duration of the catheterization increases, there is the formation of a biofilm which renders the bacteria resistant to antimicrobials and difficult to treat. CAUTIs comprise perhaps the largest institutional reservoir of ABSTRACT Background: The prevalence of catheter associated urinary tract infections (CAUTIs) in the catheterized patients in acute care settings (catheter used for <7 days) is 3%-7%, in patients who require a urinary catheter for >7 days, it is up to 25% and it approaches 100% after 30 days. As device related hospital acquired infections are imposing major threats in surgical realm of medical sciences, this study was undertaken with the objective to asses catheter related urinary tract infections magnitude. Methods: This study was undertaken in a tertiary care setting of Obstetrics and Gynecology Department of a Central Indian city. It is a prospective study conducted over a full year span from April 2016 to March 2017. Results: CAUTI was calculated as 8.95 per thousand catheter days for the whole study period. Out of the total number of 18 urinary isolates, E. Coli and Enterococcus species were more commonly implicated. Conclusions: In order to restraint the enigma, a multidisciplinary integrated approach including periodic training sessions for all health care workers based on bundled care interventions supervisory checklists etc. is needed. Aseptic techniques along with IDSA (Infectious disease society of America) guidelines/other similar protocols are recommended to bring down overall prevalence. Prudent use of antibiotics is to be accorded as per antibiotic stewardship program to combat drug resistance.

An Observational Study from Northern India to Evaluate Catheter-associated Urinary Tract Infection in Medical Intensive Care Unit at a Tertiary Care Centre

“…The route of infection can be intraluminal (from the catheter drainage tube junction) or extraluminal (contaminated collection bag). 9 …”