Catheter-associated Urinary Tract Infections: Epidemiology and Antimicrobial Resistance Profiles-A Retrospective Study of 321 Cases
Karim Boularbah *
Department of Urology, Cheikh Khalifa International University Hospital, Casablanca, Morocco.
Aymane Meskini
Department of Urology, Cheikh Khalifa International University Hospital, Casablanca, Morocco.
Moussaab Rachid
Department of Urology, Cheikh Khalifa International University Hospital, Casablanca, Morocco.
Younes Houry
Department of Urology, Cheikh Khalifa International University Hospital, Casablanca, Morocco.
Ghassane El Omri
Department of Urology, Cheikh Khalifa International University Hospital, Casablanca, Morocco and Faculty of Medicine, Mohammed VI University of Sciences and Health (UM6SS), Casablanca, Morocco.
Abdeljalil Heddat
Department of Urology, Cheikh Khalifa International University Hospital, Casablanca, Morocco and Faculty of Medicine, Mohammed VI University of Sciences and Health (UM6SS), Casablanca, Morocco.
*Author to whom correspondence should be addressed.
Abstract
Background: Urinary catheterization is one of the most frequently performed invasive procedures in urology. Urinary tract infection is its principal complication and one of the most common healthcare-associated infections.
Objective: This study aimed to describe the epidemiological and bacteriological profile of catheter-associated urinary tract infections (CAUTI) and the antimicrobial susceptibility of the isolated pathogens.
Methods: A retrospective descriptive study was conducted in the urology department of Cheikh Khalifa International University Hospital, Casablanca, Morocco, from 1 January 2023 to 31 December 2024, and included all catheterised patients with a documented urinary tract infection.
Results: A total of 321 patients were included. The mean age was 61 years (range: 17–92 years) and the male-to-female ratio was 1.55. The main indications for catheterization were bladder tumour (37%) and benign prostatic hyperplasia (32%). Catheters were most frequently inserted in the emergency department and retained for more than two weeks in 78% of cases. Gram-negative bacilli accounted for 89% of isolates, mainly Escherichia coli (54%), Klebsiella pneumoniae (17%) and Pseudomonas aeruginosa (9%). Enterobacterales showed low susceptibility to ampicillin (23%) and amoxicillin-clavulanate (31%), intermediate susceptibility to quinolones (68%), and high susceptibility to aminoglycosides (78%), imipenem (96%) and colistin (98%).
Conclusion: CAUTIs are dominated by Enterobacterales with substantial resistance to common beta-lactams. Minimising catheter duration and maintaining strict aseptic practices are central preventive measures.
Keywords: Catheter-associated urinary tract infection, urinary tract infection, urinary catheter, healthcare-associated infection, Escherichia coli, antimicrobial resistance, Morocco