Catheter-Associated Urinary Tract Infection
Somwang Danchaivijitr MD*, Chertsak Dhiraputra MD **, Rachada Cherdrungsi MSc***, Duangporn Jintanothaitavorn MSc***, Nitaya Srihapol RN***
Affiliation : *Department of Medicine, **Department of Microbiology, ***Center for Nosocomial Infection Control, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok
Objectives : To study the incidence, risk factors, clinical outcomes and antibiotic costs of catheter-associated
urinary tract infections (CAUTI) in patients with indwelling urinary catheter for one week and longer.
Materials and Methods : Patients in neurology and neurosurgery wards in a teaching hospital were studied.
Patients with UTI before catheterization and in whom the catheter was removed before one week were ex-
cluded. Urine cultures were done immediately after catheterization and 3 times a week there after. Patients
were followed for symptoms of UTI for 1 week after catheter removal, for 4 weeks without evidence of UTI or
until discharge.
Results : One hundred and one patients met the inclusion criteria. The incidence of CAUTI was 73.3%. High
incidence of CAUTI was found in the first 2 weeks after catheterization. About one-half of the patients with
CAUTI had a single episode and were symptomatic. None of the 132 episodes of CAUTI were associated with
secondary bacteremia. Risk factors for CAUTI identified were prolonged catheterization and change of the
catheter. Nosocomial pathogens were found in urine and yeast was the commonest. Eleven patients (14.9%)
with CAUTI died and only in 2, CAUTI was considered a contributory factor for mortality. The cost of antimi-
crobials for treating one episode of CAUTI was 8,180 baht and this rose to 49,983 baht for CAUTI associated
with concurrent infections at other sites.
Conclusion : Catheter-associated urinary tract infection was common. uropathogens were nosocomial micro-
organisms with high incidence of resistance to antimicrobials. Impacts on morbidity, mortality and costs were
substantial. Better management of urinary catheter is to be explored and implemented.
Keywords : Catheter-associated, Urinary tract infection
