Catheter-associated Urinary Tract Infections: Epidemiology and Antimicrobial Resistance Profiles-A Retrospective Study of 321 Cases

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.