Prevalence and causative pathogens of catheter associated urinary tract infections and compliance of healthcare workers on preventive strategies in selected intensive care units at a tertiary care centre

Introduction: Catheter associated urinary tract infection (CAUTI) is a common cause of healthcare associated infections worldwide. Surveillance on compliance rate of CAUTI prevention strategies would be important for the improvement of patient care quality.
Objectives: Assess the prevalence and causative pathogens of catheter associated urinary tract infections and compliance of healthcare workers on preventive strategies in selected intensive care units (ICU) at a tertiary care centre.
Methods: A descriptive cross-sectional study was conducted in the selected intensive care units (medical ICU and neurology ICU) at National Hospital, Sri Lanka (NHSL) from December 2021 to March 2022. Catheterised patients who stayed >48 hours in the ICU (n=146) were included in the study. Urine samples were collected according to the National Healthcare Safety Network (NHSN) criteria, United States of America (USA). Urine specimens were processed according to the standard operating procedures (SOP) and identification of the pathogens and antibiotic sensitivity were performed using an automated identification system (BD PhoenixTM).
Results: The average CAUTI rate for the study period was 7.3 per 1000 urethral catheter (UC) days and UC utilisation rate was 0.95. With improving compliance rate for UC prevention strategies, a reduction in CAUTI rate was observed from 7.9 to 1.8 per 1000 UC days. There was a statistically significant association with compliance for CAUTI prevention strategies (all or none method) with the reported CAUTI rate (p= 0.03). Common pathogens isolated in the patients with CAUTI were Escherichia coli (25%) and Enterococcus faecium (25%). Among Gram-negative pathogens, 75% were multi-drug resistant (MDR).
Conclusion: Improving the compliance rate for UC associated infection prevention strategies will have positive impact in reducing the CAUTI rate.