Dr Asmaa Hagag1, Dr Najla A. Obaid2
1King Abdullah Medical City, Makkah Al Mukaramah, Saudi Arabia, 2College of pharmacy Umm Al-Qura University, Makkah Al Mukaramah, Saudi Arabia
Biography:
Infection Prevention and Control Consultant and accreditation Programs head of department , Board and CIC certified , Infection Control Certified Solo Surveyor (CBAHI ) , Senior Quality Ambassador (SASO) , Infection Control Course Instructor, IC research Principle Investigator , Membership at Australasian College of Infection Prevention and Control / ACIPC , National and International IC accreditation Counter part ( KAMC ) , BICSL Coaching and certified trainer ( MOH ) , EFQM Certified and QMS ISO 9001 Lead Auditor .
Abstract:
Background
Catheter-associated urinary tract infections (CAUTIs)are among the most common types of healthcare-associated infections. In Saudi Arabian hospitals, there is a scarcity of data on the pathogens and factors that cause CAUTIs. This multicenter study explored antimicrobial-resistant pathogens causing CAUTIs in the intensive care unit (ICU).
Methods
A retrospective cohort study was conducted on patients in ICUs in three centers between January 2017 and December 2020.The list of pathogens that caused CAUTIs, resistant pathogens, and medications used for treating CAUTI were identified from patient records (n = 393).
Results
A total of 162 of 393(41.2%) patients from three hospitals were diagnosed with CAUTIs, of whom 55.5% were females and 67.7% were from Saudi Arabia. The patients had ages ranging from (47- 73) years, with a median weight of 75.0 kg. Around 91.1% of them had a 2-way latex catheter, whereas only 8.9% had a silicone catheter. Twenty different pathogenic microorganisms have been found to cause CAUTI, Candida albicicans (18.4%), Escherichia coli (13.5%), yeast other than Candida (10.4%), and Klebsiella pneumonia (8.5%).19.67% were antibiotic-resistant pathogens. The most resistant isolates recorded from CAUTI in the ICUs were carbapenem-resistant Enterobacteriaceae K. pneumonia (n = 17), and extended-spectrum β-lactamase K. pneumonia and E. coli (n = 11 and 19, respectively). The incidence rate of antimicrobial resistance among the study participants was 62.0%. Three cases of untreated pan-drug-resistant pathogens were recorded, Resistance to ciprofloxacin (16.5%) and trimethoprim or sulfamethoxazole (16.1%) was the most frequently observed pathogen. Importantly, antimicrobial resistance was significantly different between males and females (χ2= 4.65, P <0.031).
Conclusion
Antimicrobial-resistant pathogens pose a real challenge in ICU clinical practice.