“A Study on Prevalence, risk factors, Biofilm formation and antimicrobial resistance of uropathogens in Catheter Associated Urinary Tract Infections (CAUTI) in a Tertiary care Hospital”

Introduction : Catheter-associated urinary tract infection (CAUTI) is a urinary tract infection that develops after more than two consecutive days of catheter placement. It is the most common healthcare-associated infection and the leading cause of secondary bloodstream infections. This study aimed to determine the prevalence, risk factors, biofilm formation, and antimicrobial resistance of CAUTI pathogens in our setting. Methods: This prospective, descriptive cross-sectional study included total of 96 patients who underwent urinary catheterization in the Surgical and Medical Intensive care units (SICU and MICU) were enrolled through convenient sampling. After cleansing the port, catheter urine samples were aseptically collected from the sampling port using a sterile needle. Samples were processed in the microbiology laboratory following standard guidelines. CAUTI prevalence and its association with demographic and risk factors were analyzed. Etiological agents were identified, and their biofilm formation and antimicrobial resistance were evaluated according to CLSI guidelines. Results : Among 96 patients with an indwelling catheter for over 48 hours, CAUTI was diagnosed in 11 cases (11.45%). The highest incidence, 5(45.45%), occurred in individuals aged >61 years. Of the 11 CAUTI cases, 6 (54.54%) involved catheters retained for more than 10 days. Escherichia coli was the most common pathogen (5 cases, 45.45%), followed by Klebsiella pneumoniae (3 cases, 27.27%). Among the isolates, 6 (54.54%) demonstrated biofilm formation, and 9 (81.81%) were identified as multidrug-resistant (MDR). The CAUTI rate in the SICU was 1.08 per 1,000 catheter-days, whereas the MICU exhibited a higher rate of 2.31 per 1,000 catheter-days. Conclusion : This study highlights the significant burden of CAUTIs among patients with prolonged indwelling catheterization, particularly underscoring a notable association between extended catheter duration (>10 days) and the development of biofilm-forming infections. Escherichia coli emerged as the predominant pathogen. A significant proportion of isolates exhibited biofilm formation and multidrug resistance.