An Observational Study on Catheter-Associated Urinary Tract Infections in a Medical ICU at a Tertiary Care Center

Introduction: Catheter-associated urinary tract infection (CAUTI) is a major healthcare-associated infection (HAI), significantly contributing to prolonged hospital stays, increased morbidity, and antimicrobial resistance. The widespread use of indwelling urinary catheters in intensive care units (ICUs) makes CAUTI a critical concern, particularly in critically ill patients. As the risk of bacteriuria increases with each day of catheter use, early removal and adherence to infection control measures are crucial in preventing CAUTI-related complications. Aim and objectives: To evaluate the incidence, risk factors, microbial profile, and antibiotic resistance patterns of catheter-associated urinary tract infections (CAUTI) in ICU patients to enhance infection control strategies and antimicrobial stewardship. Materials and Methods: This hospital-based prospective observational study was conducted in the Medical Intensive Care Unit (MICU) of a tertiary care center in Western Gujarat, enrolling 100 catheterized patients. Urine samples were collected and processed for microbial identification and antibiotic susceptibility testing. Patients were monitored for clinical symptoms of CAUTI, and relevant demographic and clinical data were recorded. Bacterial isolates were identified using standard microbiological techniques, and antibiotic susceptibility was assessed following CLSI guidelines. Statistical analysis was performed using descriptive methods and chi-square tests, with a p-value <0.05 considered statistically significant. Results: A total of 100 catheterized MICU patients were monitored for CAUTI incidence, microbial profile, and antibiotic susceptibility patterns. The majority of patients were in the 51–70 years age group (34%), followed by 11–30 years (26%), with the lowest representation in those above 70 years (18%). CAUTI cases were most frequently observed in the third week of catheterization (55%), followed by the second week (35%), with the lowest occurrence in the first week (10%). Microbial analysis identified Escherichia coli (6%) as the most common pathogen, followed by Enterococcus species (4%) and Pseudomonas species (3%), while 83% of urine cultures were sterile. Antibiotic susceptibility testing revealed high sensitivity of Imipenem (90%) and Colistin (95%) against Gram-negative bacilli, while Nitrofurantoin showed 100% efficacy. Resistance was noted with Ceftazidime (55%) and Piperacillin/Tazobactam (60%), highlighting the need for judicious antibiotic use and infection control measures. Conclusion: Our study emphasizes the significant role of prolonged catheterization in CAUTI development and highlights the importance of early catheter removal, infection control measures, and antimicrobial stewardship to reduce incidence and combat antibiotic resistance in ICU settings.