Short term urinary catheterized patients in intensive care unit (ICU)--a need to screen

Catheter-Associated Urinary Tract Infection (CAUTI) is the second most commonly reported healthcare associated infection, accounting for upto 40% of all nosocomial infections. Silent catheter associated bacteriuria comprises a huge reservoir of resistant organism in hospitals particularly in critical care units. We prospectively studied 100 newly short-term catheterized patients in a tertiary care hospital. Samples collected on day three and daily thereafter for semi quantitative urine culture and pus cell count. Antibiotic sensitivity was tested using Kirby-Bauer disc diffusion method. Out of hundred patients, 32 showed growth on fifth day and remaining 68 samples were culture negative up to seventh day. None of the culture positive samples had pus cells. Escherichia coli (35%) was the predominant isolate followed by Pseudomonas aeruginosa, Klebsiella pneumoniae, Enterococcus faecium, Candida spp (15% each) and Coagulase negative Staphylococcus (5%). Among the Gram negative organisms, four strains of Escherichia coli and two strains of Klebsiella pneumonia were Extended Spectrum Beta Lactamases (ESBL) producers and 33.3% were Multidrug resistant Pseudomonas aeruginosa. Multidrug resistant pathogens in an asymptomatic short-term catheterized patient are a major reservoir in hospitals. This emphasizes the importance of periodic surveillance for nosocomial infections in hospital and the periodic screening will also help us to frame antibiotic policy in a new tertiary care hospital.