Risk Factors for Catheter-Associated Urinary Tract Infection and Uropathogen Bacterial Profile in the Intensive Care Unit in Hospitals in Medan, Indonesia

Abstract

AIM: To evaluate the risk factors of CAUTI in ICU patients at Haji Adam Malik General Hospital and Universitas Sumatera Utara Hospital, Medan, Indonesia.

METHODS: This hospital-based observational research was an observational analytic research with a cross-sectional study. This research was conducted at Haji Adam Malik General Hospital Medan, Universitas Sumatera Utara Hospital, and Department of Microbiology Medical Faculty of Medicine Universitas Sumatera Utara, on July to August 2018 until the number of samples was fulfilled. The samples were adults aged ≥18 years, admitted to an ICU between July until August 2018 with an indwelling urinary catheter during their admission, admitted in ICU with different complaints and presentations and developed clinical evidence of infection that did not originate from patient’s original admitting diagnosis, in accordance which corresponded to the inclusion criteria by using consecutive sampling technique were included in the study. Patients who were shifted out of the ICU within 48 h of admission were excluded from the study. These critical patients were referred for monitoring, observation, and management from different departments, e.g., medic, general surgery, neurosurgery, gynaecology/obstetrics, and accident/emergency departments.

RESULTS: From this research, it was found that fifty-four patients with catheter were screened for UTI infection. Of those, 24 patients (44.4%) were confirmed to have UTI by urine culture. Pseudomonas aeroginosa (16.7%) and Enterococcus faecalis (12.5%) were the most common pathogens. Patients aged > 50 years old (P < 0.03) and catheter use > 6 days (P < 0.03) were both significantly associated with increased risk of developing UTI.

CONCLUSION: There are eleven uropathogens identified in this study: Pseudomonas aeruginosa, Enterococcus faecalis, Escherichia coli, Klebsiella pneumonia, MRSA, Salmonella enteric, Acinetobacter baumanii, Acinetobacter lwoffi, Acinetobacter haemoliticus, Burkholderia cepacia, and Staphylococcus sciur.