SURVEILLANCE OF CATHETER ASSOCIATED URINARY TRACT INFECTION IN A SURGICAL INTENSIVE CARE UNIT

Abhay; R.Deepa; S.Thasneem Banu

Volume : IX, Issue : VI, June - 2020

SURVEILLANCE OF CATHETER ASSOCIATED URINARY TRACT INFECTION IN A SURGICAL INTENSIVE CARE UNIT

Abhay, R. Deepa, S. Thasneem Banu

Abstract :

Introduction: Patients in Surgical Critical care units are at high risk of developing urinary tract infections due to need for urinary catheterization for various indications and underlying risk factors. Aim: To determine incidence, risk factors and microbial profile of Catheter associated Urinary tract Infection (CAUTI) in the surgical Intensive care unit (SICU) and to determine the catheter care practices. Materials and Methods: The prospective study conducted in the SICU for a period of two months included all consecutive patients with an indwelling urinary catheter at the time or discontinued within 48 hours before onset of symptoms suggestive of urinary tract infection.Semiquantitative urine culture and antimicrobial susceptibility testing was performed by standard methods. Diagnosis of CAUTI was done according to National Health Safety Network definitions. A point prevalence survey was done to determine the indications of catheterization and Catheter care practices. Risk factor assessment was done by univariate analysis. Results: Among the 36 patients who satisfied the inclusion criteria,7 of 36 patients ( 19.4%) developed CAUTI .Among them, SUTI 1a was detected in 6 patients ( 85.7%), and SUTI 2a in 1 patient (14.3 %).The average CAUTI rate was 12.9 per 1000 catheter days. The mean duration of inserted catheter was 16.1 days. The etiological agents of CAUTI were Escherichia coli (50%),Klebsiella pneumoniae (30%)] and Enterococcus faecalis(20%).Extended spectrum betalactamase production was detected in 25% of the gram negative bacterial isolates. Duration of catheterisation was a major risk factor significantly associated with CAUTI. One day assessment of catheter care practices showed 100% compliance in 50% of catheter care practices. Conclusion: CAUTI is an important cause of hospital acquired infections in the SICU .A major modifiable risk factor is the duration of catheterisation .Preventive strategies include strict adherence to sterile catheter care practices and surveillance of the high risk areas