Bacterial Uropathogens and Antimicrobial Susceptibility Mapping among Geriatric Patients with Catheter-Associated Urinary Tract Infections

International Journal of Medicine and Medical Sciences | Vol. 14, No. 7, July 2024 | pp. 49–56

DOI: 10.46882/2024/IJMMS/140049

Original Research Article

Bacterial Uropathogens and Antimicrobial Susceptibility Mapping among Geriatric Patients with Catheter-Associated Urinary Tract Infections

Elizabeth A. Cole¹, Moses Z. Tarawallie², Victoria N. Okoye¹*

¹Department of Medical Microbiology, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone.

²Department of Medicine, Connaught Hospital, Freetown, Sierra Leone.

Abstract:

Catheter-associated urinary tract infections (CAUTIs) in geriatric patients are often caused by multidrug-resistant bio-film-forming pathogens, leading to limited options for empiric therapy. This prospective cross-sectional study identified the predominant bacterial uropathogens and mapped their antimicrobial resistance profiles among hospitalized geriatric patients presenting with signs of CAUTI. Urine samples collected from 150 catheterized patients aged ≥ 65 years were cultured. Bacterial confirmation was achieved using automated systems, and antimicrobial susceptibility testing was performed using the disk diffusion technique. Significant bacteriuria was confirmed in 58.7% (88/150) of the symptomatic participants. Pseudomonas aeruginosa was the most common isolate (31.8%), followed by Escherichia coli (27.3%), Klebsiella pneumoniae (20.5%), and Enterococcus faecalis (13.6%). Antibiogram mapping revealed high resistance rates among Gram-negative bacilli to ciprofloxacin (74.2%) and ceftazidime (68.5%). Resistance to imipenem was detected in 18.2% of the P. aeruginosa isolates. Conversely, high susceptibility rates were maintained for amikacin (88.6%) and piperacillin-tazobactam (85.2%). Extended-Spectrum Beta-Lactamase (ESBL) production was confirmed in 33.3% of the E. coli strains. Logistic regression analysis demonstrated that a catheterization duration > 7 days was strongly associated with a multidrug-resistant infection (OR = 3.8, 95% CI = 1.9–7.6, p < 0.01). CAUTIs in geriatric patients show high resistance to common oral and parenteral antibiotics. Minimizing the duration of catheter usage, practicing sterile insertion techniques, and guiding therapies by culture results are essential strategies to reduce resistance.

Keywords: Catheter-Associated Urinary Tract Infection, Geriatric Patients, Pseudomonas aeruginosa, Escherichia coli, Antimicrobial Resistance, Catheterization Duration

Manuscript Timeline: Received: April 02, 2024; Revised: May 11, 2024; Accepted: June 05, 2024; Published: July 12, 2024.

Citation: Cole EA, Tarawallie MZ, Okoye VN. Bacterial Uropathogens and Antimicrobial Susceptibility Mapping among Geriatric Patients with Catheter-Associated Urinary Tract Infections. International Journal of Medicine and Medical Sciences, 2024, 14(7): 49–56. DOI: 10.46882/2024/IJMMS/140049

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