Main Article Content
Abstract
Highlights:
- This study examined patients with catheter-associated urinary tract infections (CAUTI) to find the prevalent bacteria and the frequency of antibiotic use.
- Extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli sensitive to amikacin was found to be the most common pathogen in CAUTI, while ceftriaxone was the most commonly used antibiotic.
Abstract
Catheter-associated urinary tract infection (CAUTI) is the most typical type of infection associated with healthcare. This infection constitutes a significant health problem due to its complications and frequent recurrence. The high annual incidence of CAUTI leads to infectious complications and a high cost of treatment. Antibiotic-resistant bacteria further complicate the problem because multiresistant pathogenic bacteria are often responsible for these infections. Moreover, the lack of a comprehensive case reporting system in Indonesia hinders the determination of CAUTI incidence. This study aimed to determine the bacterial profile and antibiotic use in CAUTI patients (n=22) at the Internal Medicine Inpatient Unit of Dr. Soetomo General Academic Hospital, Surabaya, Indonesia. This retrospective descriptive study collected data from patient medical records to describe the incidence, type of bacteria, sensitivity patterns, and antibiotic use in CAUTI patients. The data collection process included collecting medical records, recording information on data collection sheets, and recapitulating and analyzing the data. The criteria for CAUTI diagnosis were a bacterial count of ≥105 CFU/mL and a catheterization that lasted more than 48 hours. Samples were selected using non-probability sampling, also known as saturation sampling. Meanwhile, variables analyzed in this study were the type of pathogenic bacteria, antibiotics used, age, and sex. Descriptive analysis was employed to analyze the data. The findings suggested that the most common bacteria were Escherichia coli, with eight of nine bacteria showing extended-spectrum beta-lactamase (ESBL) production. Female patients aged 35–65 years were the majority of the CAUTI patients. Amikacin was the antibiotic with the highest sensitivity (90.9%), while ceftriaxone was the most common type of antibiotic administered to the patients. In addition, intravenous (IV) administration was the most common route of antibiotic administration, with an average therapy duration of seven days. In conclusion, identifying the type of pathogenic bacteria and performing antibiotic susceptibility testing can help minimize antibiotic resistance and prevent more severe complications in CAUTI patients.
Keywords
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References
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- Tenke P, Köves B, Johansen TEB (2014). An update on prevention and treatment of catheter-
- associated urinary tract infections. Current Opinion in Infectious Diseases 27, 102–107. doi:
- 1097/QCO.0000000000000031.
- Urs TA, Kadiyala V, Deepak S, et al (2018). Catheter associated urinary tract infections due to
- Trichosporon asahii. Journal of Laboratory Physicians 10, 464–470. doi:
- 4103/JLP.JLP_71_18.
- Utami MDT, Wahyunitisari MR, Mardiana N, et al (2022). Bacterial and antibiogram profile of urinary tract infection patients in Tertiary Hospital, Surabaya, Indonesia. Folia Medica Indonesiana 58, 195–202. doi: 10.20473/fmi.v58i3.33186.
- Werneburg GT (2022). Catheter-associated urinary tract infections: Current challenges and future prospects. Research and Reports in Urology 14, 109–133. doi: 10.2147/RRU.S273663.
References
Anggi A, Wijaya DW, Ramayani OR (2019). Risk factors for catheter-associated urinary tract infection and uropathogen bacterial profile in the Intensive Care Unit in Hospitals in Medan, Indonesia. Open Access Macedonian Journal of Medical Sciences 7, 3488–3492. doi: 10.3889/oamjms.2019.684.
Bush K (2018). Past and present perspectives on β- lactamases. Antimicrobial Agents and Chemotherapy. doi: 10.1128/AAC.01076-18.
Chuang L, Tambyah PA (2021). Catheter-associated urinary tract infection. Journal of Infection and Chemotherapy 27, 1400–1406. doi: 10.1016/j.jiac.2021.07.022.
Clarke K (2014). Diagnosis, treatment and prevention of catheter-associated urinary tract infections. Journal of Women's Health, Issues & Care. doi: 10.4172/2325-9795.1000145.
Daoud N, Hamdoun M, Hannachi H, et al (2020). Antimicrobial susceptibility patterns of
escherichia coli among tunisian outpatients with community-acquired urinary tract infection
(2012-2018). Current Urology 14, 200–205. doi: 10.1159/000499238.
Hariati H, Suza DE, Tarigan R (2019). Risk factors analysis for catheter-associated urinary tract
infection in Medan, Indonesia. Open Access Macedonian Journal of Medical Sciences 7, 3189–3194. doi: 10.3889/oamjms.2019.798.
Karah N, Rafei R, Elamin W, et al (2020). Guideline for urine culture and biochemical identification of bacterial urinary pathogens in low-resource settings. Diagnostics 10, 832. doi: 10.3390/diagnostics10100832.
Karlović K, Nikolić J, Arapović J (2018). Ceftriaxone treatment of complicated urinary
tract infections as a risk factor for enterococcal re-infection and prolonged hospitalization: A 6-
year retrospective study. Bosnian Journal of Basic Medical Sciences 18, 361–366. doi:
17305/bjbms.2018.3544.
Köves B, Magyar A, Tenke P (2017). Spectrum and antibiotic resistance of catheter-associated
urinary tract infections. GMS infectious diseases 5, Doc06. doi: 10.3205/id000032.
Letica-Kriegel AS, Salmasian H, Vawdrey DK, et al (2019). Identifying the risk factors for catheter-
associated urinary tract infections: a large cross-sectional study of six hospitals. BMJ Open 9,
e022137. doi: 10.1136/bmjopen-2018-022137.
Li F, Song M, Xu L, et al. (2019). Risk factors for catheter"associated urinary tract infection among
hospitalized patients: A systematic review and meta"analysis of observational studies. Journal
of Advanced Nursing 75, 517–527. doi: 10.1111/jan.13863.
Musinguzi B, Kabajulizi I, Mpeirwe M, et al (2019). Incidence and etiology of catheter associated urinary tract infection among admitted patients at Kabale Regional Referral Hospital, South Western Uganda. Advances in Infectious Diseases 09, 183–196. doi: 10.4236/aid.2019.93014.
Niranjan V, Malini A (2014). Antimicrobial resistance pattern in Escherichia coli causing
urinary tract infection among inpatients. The Indian Journal of Medical Research 139, 945–948. Available at
http://www.ncbi.nlm.nih.gov/pub med/25109731.
Podkovik S, Toor H, Gattupalli M, et al (2019). Prevalence of catheter-associated urinary tract infections in neurosurgical intensive care patients–The overdiagnosis of urinary tract infections. Cureus. doi: 10.7759/cureus.5494.
Press MJ, Metlay JP (2013). Catheter-associated urinary tract infection does changing the
definition change quality? Infection Control & Hospital Epidemiology 34, 313–315. doi: 10.1086/669525.
Rishpana MS (2015). Candiduria in catheter associated urinary tract infection with special
reference to biofilm production. Journal of Clinical and Diagnostic Research. doi: 10.7860/JCDR/2015/13910.6690.
Sabir S, Anjum AA, Ijaz T, et al (1969). Isolation and antibiotic susceptibility of E. coli from
urinary tract infections in a tertiary care hospital. Pakistan Journal of Medical Sciences. doi
12669/pjms.302.4289.
Setyorini H, Mardiana N, Tjempakasari A (2019). Risk factors for urinary tract infection in
hospitalized patients. Biomolecular and Health Science Journal 2, 4. doi: 10.20473/bhsj.v2i1.11549.
Sinawe H, Casadesus D (2023). Urine culture. Available at: http://www.ncbi.nlm.nih.gov/
pubmed/11118930.
Sitepu WI, Putra A (2019). Pengaruh penerapan healthcare infection control practices advisory
committee terhadap kejadian infeksi saluran kemih terkait penggunaan kateter. Jurnal
Administrasi Rumah Sakit Indonesia. doi: 10.7454/arsi.v5i3.3175.
Smith DRM, Pouwels KB, Hopkins S, et al (2019). Epidemiology and health-economic burden of
urinary-catheter-associated infection in English NHS hospitals: a probabilistic modelling study.
Journal of Hospital Infection 103, 44–54. doi: 10.1016/j.jhin.2019.04.010.
Spoorenberg V, Hulscher MEJL, Akkermans RP, et al. (2014). Appropriate antibiotic use for patients
with urinary tract infections reduces length of hospital stay. Clinical Infectious Diseases 58, 164–169. doi: 10.1093/cid/cit688.
Tenke P, Köves B, Johansen TEB (2014). An update on prevention and treatment of catheter-
associated urinary tract infections. Current Opinion in Infectious Diseases 27, 102–107. doi:
1097/QCO.0000000000000031.
Urs TA, Kadiyala V, Deepak S, et al (2018). Catheter associated urinary tract infections due to
Trichosporon asahii. Journal of Laboratory Physicians 10, 464–470. doi:
4103/JLP.JLP_71_18.
Utami MDT, Wahyunitisari MR, Mardiana N, et al (2022). Bacterial and antibiogram profile of urinary tract infection patients in Tertiary Hospital, Surabaya, Indonesia. Folia Medica Indonesiana 58, 195–202. doi: 10.20473/fmi.v58i3.33186.
Werneburg GT (2022). Catheter-associated urinary tract infections: Current challenges and future prospects. Research and Reports in Urology 14, 109–133. doi: 10.2147/RRU.S273663.