Abstract
BACKGROUND: Catheter-associated urinary tract infections (CAUTI) lead to increased morbidity, mortality, prolonged hospital stays, and frequent antimicrobial use, potentially leading to development of multidrug-resistant pathogens. This study aimed to determine the prevalence of CAUTI and identify risk factors among patients in intensive care units (ICU) at King Abdullah Hospital (KAH), Bisha, Saudi Arabia. METHODS: A retrospective cross-sectional, hospital-based study was conducted between November 2023 and June 2024 among 327 patients admitted to the ICU at KAH and catheterized with a Foley catheter. Clinical data and general characteristics of the patients were gathered. Identification and antibiotic sensitivity testing of bacterial pathogens were performed as per standard laboratory methods. Univariate and multivariate logistic regressions identified factors associated with CAUTI. Results were presented as odds ratios with 95% confidence intervals (95% CI), and p-values < 0.05 indicated statistical significance. RESULTS: A total of 327 adult patients were enrolled, with a CAUTI prevalence of 27.8% (n = 91). Klebsiella species were the most prevalent isolate (46.2%), followed by Escherichia coli (24.2%) and Pseudomonas aeruginosa (11.0%). Cotrimoxazole exhibited the highest resistance at 74.7%, followed by cefoxitin at 52.7% and piperacillin/tazobactam at 50.5%. Independent factors associated with CAUTI included advance age (adjusted odds ratio [aOR] = 4.34, p < .001), flank pain (aOR = 17.3, p < .001), catheter duration of more than 10 days (aOR = 18.0, p = .022), urinary incontinence (aOR = 18.0, p = .006), urine retention (aOR = 50.81, p < .001), patient with comorbidity (aOR = 37.07, p = .004), number of comorbidities (aOR = 32.07, p < .001), diabetes mellitus (aOR = 35.52, p < .001), hypertension (aOR = 25.02, p = .002), chronic renal diseases (aOR = 9.03, p = .008), cardiovascular diseases (aOR = 30.22, p < .001) and chronic pulmonary diseases (aOR = 15.31, p = .005). CONCLUSION: The prevalence of CAUTI was 27.8%. We identified several factors that affect the development of CAUTI in hospitalized patients. Understanding these risk factors helps identify effective interventions. Enhanced education on catheter management for healthcare providers and patients is crucial to reducing CAUTI. CLINICAL TRIAL NUMBER: Not applicable.