Risk factors analysis for catheter-associated urinary tract infection in urology patients: A cross-sectional survey

Authors

  • Zafar Ahmad Khan Bacha Khan Medical College and Mardan Medical Complex, Mardan Pakistan
  • Adnan Akhtar Bacha Khan Medical College and Mardan Medical Complex, Mardan Pakistan

DOI:

https://doi.org/10.61529/idjp.v34i1.374

Abstract

Background: Urinary tract infection (UTI) is the most prevalent infectious condition in global healthcare facilities. Urinary tract infections are predominantly attributable to catheter insertion. Approximately 40% of infections in healthcare settings are urinary tract infections, with 80% of these cases resulting from catheter insertion. The aim of this paper is to identify and analyze the risk factors associated with catheter-associated urinary tract infections (CAUTI) in urology patients.

Material and Methods: A cross-sectional study involving 365 urology patients who needed catheterization was conducted at Bacha Khan Medical College and Mardan Medical Complex. Information on infections, catheterization, clinical features, demography, and antiseptic use was gathered. Significant risk factors were found using regression analysis after patients were categorized according to their CAUTI status.

Results: The average age of the participants was 58.2 years, and 57.5% of them were men. The majority (76.2%) had indwelling catheters, mostly for urine retention (34.5%) or post-operative treatment (41.9%). Significant risk factors for CAUTI included diabetes (AOR: 2.36), longer catheter duration (AOR: 1.27), prolonged hospitalization (AOR: 1.18), and lack of antiseptic measures (AOR: 2.09). CAUTI affected 26.8% of patients. Catheter type, age, and gender did not substantially correlate with CAUTI.

Conclusion: Prolonged catheter duration, diabetes, prolonged hospitalization, and lack of antiseptic measures are significant risk factors for CAUTI in urology patients.

Keywords: Antiseptic measures, Catheter-associated urinary tract infection, Catheter duration, Diabetes, Risk factors, Urology

References

Medina M, Castillo-Pino E. An introduction to the epidemiology and burden of urinary tract infections. Ther Adv Urol. 2019; 11: 1756287219832172. DOI: https://doi.org/10.1177/1756287219832172

Jazayeri Moghaddas A. Frequency of the bacterial agents in urinary tract infection and their antibiotic susceptibility pattern in Semnan. Koomesh. 2000; 1(4): 11-6.

Available from: https://brieflands.com/articles/koomesh-151905.pdf

Wilde MH, McMahon JM, Crean HF, Brasch J. Exploring relationships of catheter-associated urinary tract infection and blockage in people with long-term indwelling urinary catheters. J Clin Nurs. 2017; 26(17–18): 2558–71. DOI: https://doi.org/10.1111/jocn.13626

Hariati H, Suza DE, Tarigan R. Risk factors analysis for catheter-associated urinary tract infection in Medan, Indonesia. Open Access Maced J Med Sci. 2019; 7(19): 3189. DOI: https://doi.org/10.3889/oamjms.2019.798

Behrend LA. Revisiting CAUTI Prevention: A Multifaceted Approach using Lean Six Sigma. [Doctoral project, University of St Augustine for Health Sciences]. SOAR @ USA: Student Scholarly Projects Collection. 2020. https://doi.org/10.46409/sr.OGPH7615

Dunn CDR, Napier JAF. An evaluation of factors affecting the in vitro bioassay for erythropoietin. Exp Hematol. 1975; 3(6): 362–74. PMID: 250.

Chenoweth C, Saint S. Preventing catheter-associated urinary tract infections in the intensive care unit. Crit Care Clin. 2013; 29(1): 19-32. DOI: https://doi.org/10.1016/j.ccc.2012.10.005

Nicolle LE. Catheter associated urinary tract infections. Antimicrob Resist Infect Control. 2014; 3 (3). DOI: https://doi.org/10.1186/2047-2994-3-23

Fauziah W, Rochana N, Juniarto AZ. The effect of catheter-associated urinary tract infection bundle of care: a systematic review. In Proceedings of the 1st International Conference of Indonesian National Nurses Association 2018: 123-131. Available from: https://www.scitepress.org/Papers/2018/82059/82059.pdf

Parker V, Giles M, Graham L, Suthers B, Watts W, O’Brien T, et al. Avoiding inappropriate urinary catheter use and catheter-associated urinary tract infection (CAUTI): A pre-post control intervention study. BMC Health Serv Res. 2017; 17(1); 314. DOI: https://doi.org/10.1186/s12913-017-2268-2

Ehrenberg L, Fedorcsak I, Solymosy F. Diethyl pyrocarbonate in nucleic acid research. Prog Nucleic Acid Res Mol Biol. 1976; 16(C): 189–262. DOI: https://doi.org/10.1016/s0079-6603(08)60758-8

Nitzan O, Elias M, Chazan B, Saliba W. Urinary tract infections in patients with type 2 diabetes mellitus: Review of prevalence, diagnosis, and management. Diabetes, Metab Syndr Obes. 2015; 8: 129-36. DOI: https://doi.org/10.2147/dmso.s51792

Foxman B. Epidemiology of urinary tract infections: incidence, morbidity, and economic costs. Am J Med. 2002; 113(1): 5-13. DOI: https://doi.org/10.1016/s0002-9343(02)01054-9

Tsuchida T, Makimoto K, Ohsako S, Fujino M, Kaneda M, Miyazaki T, et al. Relationship between catheter care and catheter-associated urinary tract infection at Japanese general hospitals: A prospective observational study. Int J Nurs Stud. 2008; 45(3): 352–61. DOI: https://doi.org/10.1016/j.ijnurstu.2006.10.006

Flores-Mireles AL, Walker JN, Caparon M, Hultgren SJ. Urinary tract infections: epidemiology, mechanisms of infection and treatment options. Nat Rev Microbiol. 2015; 13(5): 269-84. DOI: https://doi.org/10.1038/nrmicro3432

Avalos Vizcarra I, Hosseini V, Kollmannsberger P, Meier S, Weber SS, et al. How type 1 fimbriae help Escherichia coli to evade extracellular antibiotics. Sci Rep. 2016; 6(1): 18109. DOI: https://doi.org/10.1038/srep18109

K.K D. Assessment of risk factors influencing the development of urinary tract infections among catheterized patients in University of Maiduguri Teaching Hospital (Umth). J Nursing Health Sci. 2014; 3(4): 64–71. Available from: https://www.iosrjournals.org/iosr-jnhs/pa pers/vol3-issue4/Version-1/L03416471.pdf

Vinoth M, Prabagaravarthanan R, Bhaskar M. Prevalence of microorganisms causing catheter associated urinary tract infections (CAUTI) among catheterized patients admitted in a tertiary care hospital. Int J Res Med Sci. 2017; 5(6): 2367-72. DOI: https://doi.org/10.18203/2320-6012.ijrms20172084

Walker JN, Flores-Mireles AL, Pinkner CL, Schreiber IV HL, Joens MS, Park AM, et al. Catheterization alters bladder ecology to potentiate Staphylococcus aureus infection of the urinary tract. PNAS. 2017; 114(41): E8721-30.DOI: https://doi.org/10.1073/pnas.1707572114

Sabir N, Ikram A, Zaman G, Satti L, Gardezi A, Ahmed A, Ahmed P. Bacterial biofilm-based catheter-associated urinary tract infections: Causative pathogens and antibiotic resistance. Am J Infect Control. 2017; 45(10): 1101-5. DOI: https://doi.org/10.1016/j.ajic.2017.05.009

Ronald A. The etiology of urinary tract infection: traditional and emerging pathogens. Am J Med. 2002; 113(1): 14-9. DOI: https://doi.org/10.1016/s0002-9343(02)01055-0

Gillen JR, Isbell JM, Michaels AD, Lau CL, Sawyer RG. Risk factors for urinary tract infections in cardiac surgical patients. Surg Infect (Larchmt). 2015; 16(5): 504–8. DOI: https://doi.org/10.1089/sur.2013.115

Reisner A, Maierl M, Jörger M, Krause R, Berger D, Haid A, et al. Type 1 fimbriae contribute to catheter-associated urinary tract infections caused by Escherichia coli. J Bacteriol. 2014; 196(5): 931-9. DOI: https://doi.org/10.1128/JB.00985-13

Geerlings SE. Urinary tract infections in patients with diabetes mellitus: Epidemiology, pathogenesis and treatment. Int J Antimicrob Agents. 2008; 31: 54-7. DOI: https://doi.org/10.1016/j.ijantimicag.2007.07.042

Talaat M, Hafez S, Saied T, Elfeky R, El-Shoubary W, Pimentel G. Surveillance of catheter-associated urinary tract infection in 4 intensive care units at Alexandria university hospitals in Egypt. Am J Infect Control. 2010; 38(3): 222-8. DOI: https://doi.org/10.1016/j.ajic.2009.06.011

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Published

26-03-2025

How to Cite

Khan, Z. A., & Akhtar, A. (2025). Risk factors analysis for catheter-associated urinary tract infection in urology patients: A cross-sectional survey. Infectious Diseases Journal of Pakistan, 34(1), 33–39. https://doi.org/10.61529/idjp.v34i1.374