Keywords
Catheter-associated urinary tract infection
Healthcare-associated infection
How to Cite
Abstract
Objective: To determine the prevalence, risk factors, and microbiological aetiology of catheter-associated urinary tract infection (CAUTI) among patients admitted to a general surgery unit.
Methods: This observational cohort study included 163 patients admitted to the Surgical Ward of a Tertiary Care Hospital in Islamabad from January 2024 to April 2025. Adult patients who required indwelling urinary catheterisation and were admitted to the General Surgery Unit were included. Data on demographics, catheterisation details, clinical outcomes, and microbiological results were also collected. CAUTI was diagnosed based on the CDC criteria. Statistical analyses were performed using SPSS v 28.
Results: The overall mean age was 46.78 (17.71) years (range 17-80 years). Of the 163 cases, 79 (48.5%) were male and 84 (51.5%) were female. The mean length of catheterisation and hospital stay was 2.20 (0.79) days and 3.50 (1.61) days, respectively. Patients were distributed based on their age group as follows: 64 (39.3%) in 17-40 years, 54 (33.1%) in 41-60 years, and 45 (27.6%) in 61-80 years. CAUTI Status was positive or present in 58 (35.6%) patients, whereas 105 (64.4%) had a negative status. The lengths of catheterisation for 1, 2, and 3 days were 37 (22.7%), 56 (34.4%), and 70 (42.9%) patients, respectively. The most common causative organism was Escherichia coli (46.6%), followed by Klebsiella spp. (20.7%) and Pseudomonas aeruginosa (15.5%).
Conclusion: The high prevalence of CAUTI in this cohort underscores a critical patient safety concern in resource-constrained surgical settings. The duration of catheterisation and insertion location (ER) were key, modifiable risk factors. The implementation of stringent catheter insertion and removal protocols and robust antimicrobial stewardship is urgently needed to mitigate this burden.
Keywords: Urinary tract infections, Catheter-associated urinary tract infection (CAUTI), Healthcare-associated infection
References
Gawande V, Saxena D. CAUTI: Bacteriological Profile and Clinical Manifestations in Surgical Patients; A Short-Term Study at Tertiary Care Center. Ann. Int. Med. Den. Res. 2021; 7(2):SG01-SG03.
Ramesh A, Janagond AB, Raja S, Gobinathan SP, Charles J. Microbiological profile, comorbidity, incidence, and rate analysis of catheter-associated urinary tract infections in adult intensive care units. Indian J Microbiol Res 2018;5(1):38-43. https://doi.org/10.18231/2394-5478.2018.0007
Verma S, Naik SA, Deepak TS. Etiology and risk factors of catheter-associated urinary tract infections in ICU patients. Int J Med Microbiol Trop Dis 2017; 3:65-70.
Kaur S, Dhaliwal KK, Singh DR, Randhawa RK. A Study to Assess the Prevalence of Catheter-Associated Urinary Tract Infection among Catheterized Patients Admitted in Tertiary Care Hospital, Bathinda (Punjab). International Journal of Medical Research & Health Sciences 2021; 10(7): 34-42.
Ali SR, Raqib MA, Kashif S, Shafique MA, Haseeb A, Anis A. Prevalence of catheter-associated Urinary Tract Infection (UTI) in hospitalized patients in Karachi. medRxiv.2024.06.30.24309719. https://doi.org/ https://doi.org/10.1101/2024.06.30.24309719
Shahi A, Din Z. Frequency of urinary tract infection in stroke patients with an indwelling catheter at Lady Reading Hospital, Peshawar. Pakistan Journal of Intensive Care Medicine 2025; 5(01): 72. https://doi.org/10.54112/pjicm.v5i01.72.
Stenzelius K, Laszlo L, Madeja M, Pessah-Rasmusson H, Grabe M. Catheter-associated urinary tract infections and other infections in patients hospitalized for acute stroke: A prospective cohort study of two different silicone catheters. Scandinavian journal of urology 2016; 50(6): 483–488. https://doi.org/10.1080/21681805.2016.1194459
Ahmad S, Rahman M, Hosen M, Kalam A, Shoab M, Islam MR. Frequency and risk factors of pneumonia and urinary tract infection during hospitalization in acute stroke patients. Bangladesh Journal of Neuroscience. 2016;32(2):74-84. https://doi.org/10.3329/bjn.v32i2.57444
Jitpratoom P, Boonyasiri A. Determinants of urinary tract infection in hospitalized patients with acute ischemic stroke. BMC Neurol 2023;23(1):251. https://doi.org/10.1186/s12883-023-03296-2.
Net P, Karnycheff F, Vasse M, Bourdain F, Bonan B, Lapergue B. Urinary tract infection after acute stroke: Impact of indwelling urinary catheterization and assessment of catheter-use practices in French stroke centers. Rev Neurol (Paris). 2018;174(3):145-149. https://doi.org/10.1016/j.neurol.2017.06.029.
Nawaz S, Baber ZU, Dodani SK, Jamil S, Nasim A. Microbiology and risk factors for bacteremic urinary tract infection: insights from the largest urological center in Pakistan. Int Urol Nephrol. 2025; 57(6):1699-1706. https://doi.org/10.1007/s11255-024-04357-2.
Lee YC, Hsiao CY, Hung MC, Hung SC, Wang HP, Huang YJ et al. Bacteremic Urinary Tract Infections Caused by Multidrug-Resistant Enterobacteriaceae Are Associated with Severe Sepsis at Admission: Implications for Empirical Therapy. Medicine (Baltimore). 2016;95(20):e3694. https://doi.org/10.1097/MD.0000000000003694.
Karami A, Majedi MA, Kamyari N, Vatandost S. Correlation between nurses' knowledge and practices in prevention of catheter-associated urinary tract infection (CAUTI) with UTI incidence in ICU. BMC Nurs. 2025;24(1):1252. https://doi.org/10.1186/s12912-025-03910-3
Bonkat G, Bartoletti R, Bruyere F, Cai T, Geerlings SE, Wagenlehner F, et al. Guidelines on urological infections. In: EAU Guidelines, European Association of Urology, 2019; 2019.
Kranz J, Bartoletti R, Bruyère F, Cai T, Geerlings S, Köves B et al. European Association of Urology Guidelines on Urological Infections: Summary of the 2024 Guidelines. Eur Urol. 2024 Jul;86(1):27-41. https://doi.org/ 10.1016/j.eururo.2024.03.035.
Linsenmeyer TA. Catheter-associated urinary tract infections in persons with neurogenic bladders. J Spinal Cord Med. 2018;41(2):132-141. https://doi.org/ 10.1080/10790268.2017.1415419.
Smith DRM, Pouwels KB, Hopkins S, Naylor NR, Smieszek T, Robotham JV. Epidemiology and health-economic burden of urinary-catheter-associated infection in English NHS hospitals: a probabilistic modelling study. J Hosp Infect. 2019;103(1):44-54. https://doi.org/ 10.1016/j.jhin.2019.04.010.
Merchant S, Sarpong EM, Magee G, Lapointe N, Gundrum J, Zilberberg M. Epidemiology, Microbiology and Outcomes of Catheter-Associated Urinary Tract Infection and Complicated Urinary Tract Infection in the USA. Open Forum Infect Dis. 2017 ;4(Suppl 1):S348. https://doi.org/ 10.1093/ofid/ofx163.836.
Maharjan G, Khadka P, Shilpakar GS, Chapagain G, Dhungana GR. Catheter-Associated Urinary Tract Infection and Obstinate Biofilm Producers. Can J Infect Dis Med Microbiol. 2018; 2018:7624857. https://doi.org/ 10.1155/2018/7624857.
Durant DJ. Nurse-driven protocols and the prevention of catheter-associated urinary tract infections: A systematic review. Am J Infect Control. 2017;45(12):1331-1341. https://doi.org/ 10.1016/j.ajic.2017.07.020.
Kidd EA, Stewart F, Kassis NC, Hom E, Omar MI. Urethral (indwelling or intermittent) or suprapubic routes for short-term catheterisation in hospitalized adults. Cochrane Database Syst Rev. 2015;2015(12):CD004203.
https://doi.org/ 10.1002/14651858.CD004203.pub3.
Lam TB, Omar MI, Fisher E, Gillies K, MacLennan S. Types of indwelling urethral catheters for short-term catheterisation in hospitalized adults. Cochrane Database Syst Rev. 2014;2014(9):CD004013. https://doi.org/ 10.1002/14651858.CD004013.pub4.
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
Copyright (c) 2026 Sajid Ali Shah, Muhammad Mohsin, S H Waqar, Sabeeha Malik, Ehtesham Khan, Anam Nasim