Catheter Associated Urinary Tract Infection In A Tetiary Health Institution In Kano. A Comparison Of Catheter Tip And Aspirated Urine Sample Culture

Background: The use of indwelling catheter creates an inherent risk for infection. Catheter associated urinary tract infections (CAUTIs) comprise perhaps the largest institutional reservoir of nosocomial antibiotic resistant pathogens. This could lead to complications such as pyelonephritis and bacteraemia. Objective: To compare catheter tip cultures with aspirated urine cultures in the diagnosis of CAUTIs. Method/subjects: A prospective study of catheter tip and aspirated urine samples collected from the lumen of the catheter from 210 patients (pts) catheterized for up to 7days was carried out. These were sent to microbiology department Aminu Kano Teaching Hospital (AKTH) for bacteriological analysis between January 2005 and March 2006. Bacterial and fungal isolates were identified by standard procedures. Antibiotic susceptibility pattern was done by disc diffusion method. Results: Out of 210patients studied, 180patients (85.7%) showed bacterial and fungal isolates from catheter tip cultures while 85patients (40.5%) showed bacterial growth from the aspirated urine sample. Among the positive culture of the catheter tips 111patients (61.6%) were males while 69patients (38.3%) were females. For the aspirated urine sample 56patients (65.8%) were females while 29patients (34.1%) were males. The prevalence rates of the isolates for catheter tip and aspirated urine culture were E. coli 69 (38.3%), 35 (41.2%). Pseudomonas aeruginosa 36 (20%), 16 (18.8%) Klebsiella spp. 25 (13.8%), 12(41.1%) Proteus spp. 23 (12.7%), 10 (11.8%) S. aureus 16 (8.8%), 4 (4.7%) Streptococcus spp 2 (1.1%), 6 (7.1%) Citrobacter freundii 5 (2.7%) 0 (0%), Candida spp 5 (2.7%), (0%) and S. epidermides 2(1.1%), 0 (0%) respectively. Conclusion: Catheter tip samples always yield bacterial and or fungal growth that cannot be quantified. In the presence of pyuria, aspirated urine samples are preferred to catheter tip which can be quantified and are more reliable. Keywords: CAUTIs, Catheter tip, Aspirated urine, AKTHHighland Medical Research Journal Vol. 5 (2) 2007 pp. 31-3