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Risk Factors for Multiresistant Catheter-Associated Urinary Tract Infection in the Paediatric Critical Patient

Cristina González-Anleo1,2, Mònica Girona-Alarcón2,3,4,5, Sara Bobillo-Perez2,3,4

  • 1Pharmacy Department, Hospital Sant Joan de Déu, Barcelona, Spain.

Acta Paediatrica (Oslo, Norway : 1992)
|May 28, 2025
PubMed

Insights

Multidrug-resistant catheter-associated urinary tract infections (MDR-CAUTIs) are a significant concern in pediatric ICUs. Key risk factors include prior colonization, previous MDR infections, and early antibiotic exposure, impacting treatment success.

Area of Science:

  • Infectious Diseases
  • Critical Care Medicine
  • Microbiology

Background:

  • Catheter-associated urinary tract infections (CAUTIs) are prevalent in pediatric intensive care units (PICUs).
  • High rates of multidrug resistance (MDR) among CAUTIs complicate treatment and worsen patient outcomes.
  • Identifying specific risk factors for MDR-CAUTIs is crucial for effective management.

Purpose of the Study:

  • To identify specific risk factors associated with multidrug-resistant CAUTIs in the PICU.
  • To compare clinical outcomes between MDR-CAUTI and non-MDR CAUTI cases.
  • To inform empirical antibiotic therapy strategies for CAUTIs.

Main Methods:

  • A single-center, prospective, observational study was conducted from 2015 to 2022.
  • Included were PICU patients with microbiologically confirmed CAUTIs.
  • Demographic, clinical, microbiological data, and outcomes were compared between MDR and non-MDR CAUTI groups.

Main Results:

  • Of 91 CAUTI episodes, 35.2% were caused by MDR microorganisms.
  • Independent risk factors for MDR-CAUTI included previous MDR colonization (OR 6.056), previous MDR infection (OR 9.153), and antibiotic exposure within the first 48 hours (OR 3.029).
  • MDR-CAUTI cases showed higher empirical treatment inappropriateness (39.3% vs. 7.1%) and longer hospital stays, but no difference in mortality.

Conclusions:

  • The prevalence of MDR-CAUTIs in PICUs is concerning and compromises empirical treatment efficacy.
  • Recognizing risk factors for MDR-CAUTI is essential for optimizing empirical antibiotic selection.
  • Further research may focus on targeted interventions to reduce MDR-CAUTI incidence and improve patient outcomes.
Abstract

Keywords:
catheter‐associated urinary tract infectionhealthcare‐associated infectionmultidrug‐resistant infectionpaediatric intensive care unit

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