Abstract:
Background: Catheter-associated urinary tract infection (CAUTI) is one of the most common health-care-acquired infections, with a significant morbidity and mortality. In developing countries, the rise in health-care-acquired infections and the advent of multidrug resistance microorganisms are becoming a severe problem. As a result, current knowledge on the resistance profile of nosocomial pathogens is essential for selecting empirical therapeutic approaches.
Objective: To determine the incidence of catheter-associated urinary tract infection and the carbapenemase and extended-spectrum beta-lactamase production profiles of Gram-negative bacilli, as well as to identify risk factors for catheter-associated urinary tract infection.
Methods: Hospital based prospective cross-sectional study was conducted on 363 catheterized patients in specialized hospitals of Bahir Dar Town from 1st May to 30th July 2022. Socio- demographic data and clinical information were collected through interviewer administered questionnaire and review of medical records. Urine sample was collected, cultured on MacConkey agar and susceptibility test was performed using Kirby Bauer disk diffusion test on Muller Hinton agar. Extended-spectrum beta lactamase and carbapenemase production were detected by Chromatic ESBL and Chromatic CRE agar, respectively and identified following standard protocols. P value
<0.05 were taken as statistically significant.
Results: The overall incidence rate of catheter-associated urinary tract infection was 27.8/1000 catheter days. E. coli was the most frequent isolate 18(34.6%) followed by Proteus spp. 7 (13.5%) and P. aeruginosa 6 (11.5%). Overall, 10 (19.2%) and 3 (5.8%) of gram-negative isolates were extended spectrum beta-lactamase and Carbapenemase producers respectively. Gram negative bacilli isolates were highly resistant to amoxicillin-clavulanic acid (100%), cefazolin (98%), ceftazidime (90%) and cefotaxime (88%) and 86.5% were multidrug resistant. Prolonged catheterization (P: 0.009), prolonged hospitalization (P: 0.001) and patient’s wards (P: 0.04) were the factors significantly associated with catheter-associated urinary tract infection.
Conclusion: Higher incidence rate of catheter-associated urinary tract infection is found in this study. The production of extended-spectrum beta lactamase and carbapenemase among Gram- negative bacilli is an alarming issue. Prolonged catheterization and hospital stay were factors associated with catheter-associated urinary tract infection. Therefore, careful use of catheters and wise use of antibiotics are recommended to reduce catheter-associated urinary tract infection.
Key words: Catheter associated Urinary tract infection, Extended-spectrum beta lactamase, Carbapenemase, Gram-negative bacilli, Bahir Dar