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. 2023 Mar 20;3(1):e55.
doi: 10.1017/ash.2022.340. eCollection 2023.

Bacterial species and antimicrobial resistance differ between catheter and non-catheter-associated urinary tract infections: Data from a national surveillance network

Stéphanie D'Incau  1   2 , Andrew Atkinson  2 , Lorenz Leitner  3 , Andreas Kronenberg  4 , Thomas M Kessler  3 , Jonas Marschall  2   5
Affiliations

Bacterial species and antimicrobial resistance differ between catheter and non-catheter-associated urinary tract infections: Data from a national surveillance network

Stéphanie D'Incau et al. Antimicrob Steward Healthc Epidemiol. .

Abstract

Objective: To investigate clinically relevant microbiological characteristics of uropathogens and to compare patients with catheter-associated urinary tract infections (CAUTIs) to those with non-CAUTIs.

Methods: All urine cultures from the calendar year 2019 of the Swiss Centre for Antibiotic Resistance database were analyzed. Group differences in the proportions of bacterial species and antibiotic-resistant isolates from CAUTI and non-CAUTI samples were investigated.

Results: Data from 27,158 urine cultures met the inclusion criteria. Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Proteus mirabilis together represented 70% and 85% of pathogens identified in CAUTI and non-CAUTI samples, respectively. Pseudomonas aeruginosa was significantly more often detected in CAUTI samples. The overall resistance rate for the empirically often-prescribed antibiotics ciprofloxacin (CIP), norfloxacin (NOR), and trimethoprim-sulfamethoxazole (TMP-SMX) was between 13% and 31%. Except for nitrofurantoin, E. coli from CAUTI samples were more often resistant (P ≤ .048) to all classes of antibiotics analyzed, including third-generation cephalosporines used as surrogate for extended-spectrum β-lactamase (ESBL). Significanty higher resistance proportions in CAUTI samples versus non-CAUTI samples were observed for CIP (P = .001) and NOR (P = .033) in K. pneumoniae, for NOR (P = .011) in P. mirabilis, and for cefepime (P = .015), and piperacillin-tazobactam (P = .043) in P. aeruginosa.

Conclusion: CAUTI pathogens were more often resistant to recommended empirical antibiotics than non-CAUTI pathogens. This finding emphasizes the need for urine sampling for culturing before initiating therapy for CAUTI and the importance of considering therapeutic alternatives.

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Conflict of interest statement

All authors report no conflicts of interest relevant to this article.

Figures

Fig. 1.
Fig. 1.
Resistance rates (%) among the most frequent uropathogens (y-axis). Note. * P < .05; ** P < .01; and *** P < .001. C3G, ceftriaxone; CIP, ciprofloxacin; NOR, norfloxacin; TMP-SMZ, trimethoprim-sulfamethoxazole; FFM, fosfomycin; NIT, nitrofurantoin; AMC, amoxicillin/clavulanic acid; CEF, cefepime; PIP, piperacillin-tazobactam; CAZ, ceftazidime; IMI, imipenem.
See this image and copyright information in PMC

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