Urinary Pathogens and Their Antimicrobial Susceptibility in Patients with Indwelling Urinary Catheter

Abstract

The indwelling urinary catheter (IUC) is the most significant risk factor for developing nosocomial urinary tract infections (UTIs). In order to determine the spectrum of bacterial etiology and antibiotic resistance pattern of uropathogens causing catheter associated UTI, a convenient sample size of ninety-two (92) patients on urethral catheter was investigated. Ethical approval for the study was obtained from the OAUTHC research and ethical committee. Catheter stream urine samples were obtained from all patients and cultured on appropriate culture media. Suspected isolates were identified by a combination of standard tests and using MICROBACT GNA12A/B/E. Susceptibility of the isolates against thirteen (13) antibiotics was performed by the disc diffusion method. Significant bacteriuria was observed in 60.9% (56) catheter specimen urine (CSU) received, while 39.1% (36) were culture negative. Of the 56 positive culture, the predominant organisms were Klebsiella oxytoca, 28.6 %( 16), Proteus vulgaris, 23.2% (13) and Staphylococcus aureus, 12.5% (7). Overall, the antimicrobial susceptibility results showed that all the isolates were highly resistant to the antibiotics tested. Over 50% resistance was recorded for trimethoprim/sulfamethoxazole, gentamicin and amoxicillin/clavulanic acid. More than 25% of the isolates were resistant to nitrofurantoin. This study indicates that catheter stream UTI caused by multiply resistant bacteria are common in our hospital. There is a need to establish standard guidelines on the care of catheter for all units in the hospital with a view to preventing nosocomial infections associated with the use of the catheter in patients. We also advocated prudent use of antibiotics. Key words: Antibiotic resistance, Urinary catheter, Uropathogens, Urinary tract infection Received 27 March 2010/ Accepted 1 June 2010 INTRODUCTIONUrinary tract infections (UTIs) are the most common infections found in the hospital as well as long-term care setting. The indwelling urinary catheter (IUC) is the most significant risk factor for developing catheter-associated urinary tract infections (CAUTIs). The risk of acquiring a urinary tract infection depends on the method and duration of catheterisation, the quality of catheter care, and host susceptibility among others. Several studies have indicated that between 75 and 80% of all healthcare associated UTIs follow the insertion of a urinary catheter (Bryan and

Molecular Epidemiology of Extended Spectrum Beta-lactamases Producing Escherichia coli and Klebsiella Species in Catheterized Patients

“…The disparity may not be unconnected with the fact that their study participants were not on prolonged catheterization as the participants in this study. However, our work was in agreement with that of other workers [33], [34] but much lower than the findings of Taiwo and Aderounmu in 2006 [35], all of which were within the same geographic region. It is also interesting to note that in this study, Klebsiella spp (16.8%) was the most prevalent etiologic agent of CAUTI which is contrary to most of the earlier studies in which literature where E. coli appears to be the most prevalent agent [33], [36], [37] but it is consistent with the work of Panders et al in 2003 [38].…”

Magnitude of Biofilm Formation and Antimicrobial Resistance Pattern of Bacteria Isolated from Urinary Catheterized Inpatients of Jimma University Medical Center, Southwest Ethiopia

“…In this study, catheterization for seven or more days was identified as a risk factor for development of bacteriuria among urinary catheterized inpatients of JUMC. Similar findings have been reported in various countries around the world [23, 31, 34, 45–51] including Ethiopia [32]. This may be because the longer time the catheter remains in the urinary system, it is highly likely bacteria can colonize, accumulates in the residual urine in the bladder, adhere or aggregate, and form complex communities of bacterial species called biofilms [11, 20].…”

Magnitude and Factors Associated with Catheter Associated Urinary Tract Infection, and Antimicrobial Susceptibility Profile at Hawassa, Sidama Regional State, Ethiopia: A prospective Cross-sectional Study

“…Cotrimoxazole (20), Arbaminch, Ethiopia (16.8%) (11), China(15.8%) (21), Uganda (15.3%) (22), Sudan 16.4% (23), and Chhattisgarh, India (10.6%) (24). Our finding is lower than studies conducted in India 42.9% (25), and Nigeria 60.9% (26). The variation could be due difference in sociodemographic characteristics, infection prevention policies, duration of catheterization, and immunological status of participants.…”