Unveiling Excellence in Healthcare: The Imperative of CAUTI Rate Surveillance

This chapter evaluates the CAUTI rate and the predominant organisms in the hospital with their susceptibility patterns. Catheter-associated urinary tract infection (CAUTI) is a prevalent healthcare-associated infection that affects various parts of the urinary system, including the urethra, bladder, ureters, and kidney. CAUTIs account for up to 40% of all health-related infections and are the most common type of infection after catheterization, with a rate of 1.41 per 1000 catheter days. It is estimated that 4% of patients with bacteriuria will eventually develop clinically significant bacteriuria, resulting in a death rate of 13-30%. The risk of acquiring bacteriuria increases over time after catheterization, with a daily risk ranging from 3% to 10%.

To gain insights into the prevalence of CAUTIs and the susceptibility patterns of organisms, a study was conducted in a 330-bed tertiary care teaching hospital in Hyderabad, South India. The study focused on five intensive care units (ICUs) and medical wards catering to various surgical and medical specialties. Over a period of 24 months, 1258 cases of Foley's catheterization were followed up. The cases were confirmed based on the NABH Standards and Centers for Disease Control and Prevention guidelines. Out of the 1258 catheterized individuals, 46 cases of CAUTI were confirmed, with 29 cases in 2018 and 17 cases in 2019. The most common isolate was Escherichia coli, accounting for 41.86% of the cases. The isolates exhibited reduced susceptibility to other urinary antibiotics and resistance to cotrimoxazole, fluoroquinolones, and second and third-generation cephalosporins.

It is crucial to avoid unnecessary catheter insertion as it can lead to increased patient expenses, longer hospital stays, and higher morbidity rates. In cases where Foley catheter insertion is necessary, it is essential to follow aseptic precautions during the insertion process and remove the catheter as soon as possible. Additionally, health worker training and surveillance by infection control teams play a significant role in improving practices and reducing infections.

Timely education about CAUTI, as well as other complications of urinary catheterization and alternatives to indwelling catheters, is crucial. Continuous education and training of health workers, along with monitoring by infection control teams, are vital in improving practices and reducing the incidence of infections.

CAUTI is a significant healthcare burden, with high rates of antibiotic resistance. Preventive measures, such as avoiding unnecessary catheter insertion and implementing infection control practices, can help reduce morbidity, hospital stays, and patient costs. By raising awareness and providing education, healthcare professionals can contribute to the prevention and management of CAUTIs effectively.