MICROBIAL FLORA AND RISK FACTORS ASSOCIATED WITH CATHETER ASSOCIATED URINARY TRACT INFECTIONS

INTRODUCTION: Catheter associated Urinary Tract Infection (UTI) represent the most common type of nosocomial infection and is a major health concern due to its complications and frequent recurrence. Among the nosocomial infections UTI contributes a major part. About 80% of nosocomial UTI are associated with using indwelling urinary catheters and most of them are asymptomatic. Only 5% of them develops symptomatic UTI which leads to development of complications like bacteremia & pyelonephritis. MATERIALS AND METHODS: In the present study a random collection of 100 urine samples from different clinical "groups" like surgery, urology, AMCU, Obstetrics & Gynecology patients with indwelling urinary catheter of different durations of catheter stay. Organisms isolated in culture, biochemical characterization, and antibiotic susceptibility was done. RESULTS: Among the samples tested 41/100 (41%) showed culture positivity. within them surgery patients were 40.90% (18/41), Urology accounted for, 71.42% (20/28), in AMCU patients 20% (2/10), with more than 3 days of duration of catheter stay and in Obs & Gyn department showed 0 culture positivity. The predominant organism isolated is pseudomonas aeruginosa (34.2%), followed by Escherichia coli (22%), enterococci (12.19%), Klebsiella (12.19%) and Candida 19.5%. Among GNB 90% showed ESBL production, 10% beta-lactam inhibitors resistance, 90% quinolones resistant, 50% resistant to amikacin, 100% to gentamycin was observed. CONCLUSION: Incidence of bacteriuria in patients with indwelling urinary catheters is 41%. Onset of bacteriuria is as early as on 3rd day of catheterization, and gradually increases with duration of stay, technique of insertion and daily catheter care done. Pseudomonas aeruginosa and Escherichia coli are common organisms isolated. Use of prophylactic antibiotics without doing culture, and antibiotic susceptibility testing leads to development of drug resistant organisms. So, active surveillance of infection is the most effective method to control the CA UTI s.