URETHRAL CATHETERISATION: ROLE IN URINARY TRACT INFECTION

Abstract

The role of urethral catheterisation in the development of urinary tract infection (UTI) among patients in the University of Benin Teaching Hospital (UBTH), Benin City was studied. Mid-stream urine samples were collected from catheter tips of 112 catheterised patients. These were analysed and cultured using blood, MacConkey and Cysteine Lactose Electrolyte Deficient (CLED) agar. Out of the 112 patients studied, 77 (68%) had catheter-associated urinary tract infection (CAUTI), with the male subjects recording higher prevalence rate (70.7%) than the females (60.8%). This difference was statistically significant at p<0.05. Microbial isolates identified were as follows: Klebsiella aerogenes 28 (36.3%), Escherichia coli 13(16.8%), Proteus mirabilis 10(12.9%), Staphylococcus aureus 9(11.6%), Proteus vulgaris 8(10.3%), Pseudomonas aeruginosa 4(5.1%), Enterobacter aerogenes 3(3.8%) and Candida albicans 2(2.5%). The organism‘s resistance against 10 antibiotics was conducted. Resistance rates observed were as follows: nitrofurantoin (90.6%), ampicillin (98.6%), tetracycline (100%), cotrimoxazole (98.6%), streptomycin (98.6%) nalidixic acid (98.6%), augmentin (58.6%), gentamicin (62.6%), ofloxacin (62.6%) and ciprofloxacin (61.3%). This study showed that the drug of choice for the management of CAUTI were ofloxacin and ciprofloxacin since most of the organisms isolated were susceptible to them. Urethral catheterisation has also been implicated as one of the predisposing factors in UTI. This medical procedure should be performed when less invasive measures are not feasible.