CAUTI IN GENERAL SURGERY WARDS – ANALYSIS OF INCIDENCE, PATHOGENS AND RISK FACTORS

Dr. Neeta Jangale, Dr. Kamlesh Vishwakarma

Abstract


Background-Around 80% of hospital acquired urinary tract infections are catheter associated, most important pathogens being multidrug-resistant Enterobacteriacae. Important risk factors associated with CAUTI include prolonged catheterization,  insertion of the catheter outside of the operating room, and  inadequate professional  training of the person inserting the catheter.

Methodology-With this background, present study was undertaken with the aim to know the prevalence of CAUTI in general surgery patients, bacterial pathogens and risk factors. Patients posted for planned surgery and catheterized were included. Diagnosis was based on clinical and laboratory criteria.

Results & Conclusion- Incidence of CAUTI was 28.04% with  preponderance of gram negative bacilli .90% of isolates were multi-drug resistant. Significant alterable risk factors observed include attempts >1, surgery duration, catheterization duration, duration of hospitalization, staff category doing catheterization. Therefore, alterable risk factors should be taken care to reduce CAUTI.


Keywords


CAUTI, pathogens, risk factors

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References


Scheckler, W.E. (1978). Nosocomial infections in a community hospital. Arch Intern Med, 138(12), 1792-1794. doi:10.1001/archinte.1978.03630370022013

Rajika, L., Munasinghe, Hina, Y., Mohamed, S., &Wasif, H. (2001) Appropriateness of Use of Indwelling Urinary Catheters in Patients Admitted to the Medical Service. Infect Control Hosp Epidemiol, 22(10), 647-649.doi:10.1086/501837

Catheter-Associated Urinary Tract Infection (CAUTI) Prevention Toolkit (March 2011) Available at www.amerinet-gpo.com. Accessed on 04/06/2011

Wald, H.L., Ma, A., Bratzler, D.W., & Kramer, A.M. (2008) Indwelling urinary catheter use in the postoperative period: analysis of the national surgical infection prevention project data. Arch Surg,143(6),551-557, doi: 10.1001/archsurg.143.6.551

Stark, R.P., & Maki, D.G.(1984) Bacteriuria in the catheterized patient-What quantitative level of bacteriuria is relevant?. N Engl J Med , 311(9),560-64.DOI:10.1056/NEjJM198408303110903

Maki, D.G.(1981) Nosocomial bacteremia. An epidemiologic overview. Am J Med , 70 (3),719-32.DOI:10.1016/0002-9343(81)90603-3

Krieger, J.N., Kaiser, D.I.L.,& Wenzel, R.P. (1983) The urinary tract etiology of the bloodstream infections in hospitalized patients. J Infect Dis, 148 (1 ),57-62.DOI: 10.1093/infdis/148.1.57

Maki, D.G. & Tambyah, P.A. (2001) Engineering Out the Risk for Infection with Urinary Catheters. Em Infect Dis Mar–Apr 7 ( 2), 342-47. DOI:10.3201/eid0702.010240

Bryan, C.S., & Reynolds, K.L. (1984) Hospital Acquired Bacteremic Urinary Tract Infection: Epidemiology and Outcome. J Urol, 132(3 ),494-498.DOI:10.1016/s0022-5347(17)49707-2

Gould, C.V., Umscheid, C.A., Aggarwal, R.K., Kuntz,G.,& Pegues,D.A.(2009 )Healthcare Infection Control Practices Advisory Committee. Guideline for prevention of catheter-associated urinary tract Infections

Catheter-Associated Urinary Tract Infection (CAUTI) Event CDC( 2009) Prevention of Catheter associated urinary tract infections 2009. Available at www.cdc.gov/nhsn/pdfs/pscManual/7pscCAUTIcurrent.pdf Accessed on 01/06/2013

Kamat, U.S., Fereirra, A., Motghare, D.D., & Kulkarni, M.S. (2009) Epidemiology of hospital acquired urinary tract infections in medical college hospital in Goa. Indian J Urol , 25(1),76-80. DOI: 10.4103/0970-1591.45542

Washington, C.W., Stephen, D.A., William, M.J., Elmer, W.K., Gary, W.P., Paul, C.S. (2006) Konneman’s Color Atlas and Textbook of Diagnostic Microbiology (6th ed),Lippincott Williams and Wilkins. Introduction to microbiology, Chapter 1-2. In: pg 2-105

Amani, E.K., Tamer, S., Mervat, G., Mariam ,A., Younan , Mona,M.A. ,Haleim , Hanan E.S. ,Hanaa’a, E.K., Hafez, B., &Talaat, M.( 2009) Device-associated nosocomial infection rates in intensive care units at Cairo University hospitals: First step toward initiating surveillance programs in a resource-limited country. Am J Infect Control ,40,216-26.

Emori, T.G. & Gaynes, R.P. (1993) An Overview of Nosocomial Infections, Including the Role of the Microbiology Laboratory. Clin Microbiol Rev, 6(4), 428-442. DOI: 10.1128/cmr.6.4.428

Talaat, M., Hafez, S., Saied, T., Elfeky, R., El-Shoubary, W., & Pimentel, G. (2010) Surveillance of catheter-associated urinary tract infections in 4 intensive care units at the Alexandria university hospitals in Egypt. Am J Infect Control, 38(3),222-28. DOI: 10.1016/j.ajic.2009.06.011

Hussain, M., Oppenheim, P., O’Neill C, et al( 1996 ) A prospective survey on the incidence, risk factors and the outcome of hospital-acquired infections in the elderly. Journal of Hospital Infection, 32(2 ),117-26. DOI: 10.1016/s0195-6701(96)90053-5

Datta, P., Rani, H., Chauhan, R., Gombar, S., & Chander, J. (2014) Health-care-associated infections: Risk factors and epidemiology from an intensive care unit in Northern India. Indian J Anaesth,58(1),30-5.DOI 10.4103/0019-5049.126785

Al-Sweih, N., Jamal,W., & Rotimi, V.O.(2005) Spectrum and Antibiotic Resistance of Uropathogens Isolated from Hospital and Community Patients with Urinary Tract Infections in Two Large Hospitals in Kuwait. Med Princ Pract, 14( ), 401-407. DOI: 10.1159/000088113

Habte, T.M., Dube, S., Ismail, N., & Hoosen, A.A. (2009)Hospital and Community Isolates of Uropathogens at A Tertiary Hospital in South Africa. S Afr Med J, 99(8 ), 584-7.

Khan, B.A., Saeed, S., Akram, A., Khan, F.B., Nasim, A. (2010) Nosocomial Uropathogens and their Antibiotic Sensitivity Patterns in a Tertiary Referral Teaching Hospital in Rawalpindi, Pakistan. J Ayub Med Coll Abbottabad-JAMC, 22(1), 11-12.

Alavaren, H.F., Lim, J.A., Velmonte, M.A., & Mendoza, M.T. (1993)Urinary Tract Infection in Patients with Indwelling Catheter. Phil J Microbiol Infect Dis,22(2):65-74.

DOI: http://dx.doi.org/10.3126/acclm.v3i2.19675

Garibaldi, R.A., Burke, J.P., Dickman, M.L., & Smith, C.B. Factors predisposing to bacteriuria during indwelling urethral catheterization. (1974) N Engl J Med, 291( ), 215-219. DOI:10.1056/NEJM197408012910501

Tang, K.K., Wong, C.K., Lo, S.F., & Ng, T.K. (2005)Is it necessary to catheterize the

bladder routinely before gynecological laparoscopic surgery? Aust N Z J Obstet

Gynaecol, Oct 45(5), 380-383. DOI:10.1111/j.1479-828X.2005.00443.x

Ksycki, M.F., & Namias, N. (2009) Nosocomial Urinary Tract Infection. Surg Clin N Am 89, 475-481.


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