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. 2023 Jun;34(6):1195-1201.
doi: 10.1007/s00192-022-05320-4. Epub 2022 Aug 22.

Impact of urinary catheter on resistance patterns and clinical outcomes on complicated urinary tract infection

Carlos Ernesto Lombo Moreno  1 , Oscar Mauricio Muñoz Velandia  2   3 , Cindy Alejandra Bonilla Sánchez  2 , Juan Sebastián Montealegre Diaz  4 , Javier Ricardo Garzón Herazo  2   4
Affiliations

Impact of urinary catheter on resistance patterns and clinical outcomes on complicated urinary tract infection

Carlos Ernesto Lombo Moreno et al. Int Urogynecol J. 2023 Jun.

Abstract

Introduction and hypothesis: Complicated urinary tract infection (cUTI) is highly prevalent and costly for health systems. The impact of the indwelling urinary catheter on etiologic agents and clinical outcomes has been poorly studied in Latin America.

Methods: Cross-sectional study including patients with cUTI, with positive urine culture, treated at Hospital Universitario San Ignacio, Bogotá (Colombia) between 2017 and 2020. Clinical and microbiologic characteristics, treatments and outcomes are explored, comparing those with and without indwelling urinary catheter.

Results: Seven hundred thirty-five patients with non-catheter-associated cUTI (NC-cUTI) and 165 with catheter-associated cUTI (CAUTI) were included. CAUTI group had a higher proportion of recurrent UTI (18% vs 33.3%, p < 0.001), ICU requirement (2.7% vs 8.5%, p < 0.001), longer hospital stay (6 vs 10 days, p < 0.001) and > 30 days unplanned readmission rate (5.8% vs 10.3%, p < 0.001). In the same group, we found a higher frequency of Pseudomonas spp (2.6% vs 9.4%, p < 0.001), Enterococcus spp. (2.4% vs 3.3%, p = 0.016), Serratia marcescens (0.6% vs 3.3%, p < 0.001) and Citrobacter freundii (0.5% vs 5.7%, p < 0.001). It implied a higher number of patients treated with fourth-generation cephalosporins (1.4% vs 4.8%, p = 0.004), ertapenem (32.9% vs 41.8%, p = 0.027) and carbapenems associated with a second antibiotic (1.9% vs 8.5%, p < 0.001).

Conclusions: Patients with CAUTI have a higher frequency of resistant germs, require greater use of resources and have worse clinical outcomes than patients who do not require such devices. Measures should be strengthened to minimize its use, in both the hospital and outpatient setting.

Keywords: Colombia; Epidemiology; Microbiology; Urinary tract infection.

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Conflict of interest statement

None.

Figures

Fig. 1
Fig. 1
Complicated urinary tract resistance profile according to (A) non-catheter-associated urinary tract infection and (B) catheter-associated urinary Tract infection
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