Pathogens and Risk Factors of Catheter-associated Urinary Tract Infections in Children at King Saud University Medical City in Riyadh, Saudi Arabia

Abstract Context: Urinary tract infections (UTIs) are among the most common hospital-acquired infections, with urinary catheterization contributing to 75% of cases. Catheter-associated UTIs (CA-UTIs) in pediatric patients can lead to increased morbidity and complications, requiring targeted prevention and management strategies. Aims: This study aimed to determine the prevalence of CA-UTIs in children, identify the causative organisms, and assess associated risk factors. Settings and Design: A retrospective cross-sectional study was conducted at King Saud University Medical City in Riyadh, Saudi Arabia. Subjects and Methods: The study included children aged 14 years and below with positive urine cultures between August 2019 and August 2023. Data on demographics, clinical presentations, risk factors, and microbiological findings were analyzed. Statistical Analysis Used: Categorical variables were analyzed using the Chi-square test, with statistical significance set at P < 0.05. Results: Among 827 pediatric UTI cases, 17.8% were catheter associated. Escherichia coli was the most common pathogen (60.4%), with a lower prevalence in catheterized patients (44.8%) than noncatheterized patients (63.7%). Fever was more frequent in noncatheterized patients (64.1%, P = 0.038), while voiding symptoms were more common in catheterized patients (31.4%, P = 0.019). Recurrent UTI was a major risk factor (42%), with 27.3% of affected patients being catheterized ( P = 0.001). Extended-spectrum beta-lactamase resistance was found in 146 cases, with no significant difference between groups ( P = 0.693). Conclusions: CA-UTIs in children exhibit distinct clinical and microbiological characteristics. Recognizing risk factors and pathogen distribution is crucial for optimizing prevention and treatment strategies.