The pathogens that cause catheter-associated urinary tract infections (CAUTIs) are more likely to resist antibiotic treatment than the organisms that cause non-CAUTIs, investigators have concluded.
Their study involved approximately 70% (24,000) of all the urine cultures processed in Swiss laboratories in 2019.
Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa and Proteus mirabilis together accounted for 70% pathogens identified in CAUTI samples and 85% of non-CAUTI samples, respectively. P. aeruginosa was significantly more often detected in CAUTI samples.
Resistance rates
The overall resistance rate for the commonly prescribed antibiotics ciprofloxacin (CIP), norfloxacin (NOR) and trimethoprim-sulfamethoxazole was between 13% and 31%. E. coli from CAUTI samples had a higher resistance rate to all antibiotics except for nitrofurantoin, the researchers reported. K. pneumoniae and P. mirabilis showed differences only for resistance to quinolones.
In addition, “significantly higher resistance proportions in CAUTI samples versus non-CAUTI samples were observed for CIP and NOR in K. pneumoniae; for NOR in P. mirabilis; and for cefepime and piperacillin-tazobactam in P. aeruginosa,” they reported. One standout comparison was P. aeruginosa, which represented 10% of CAUTI pathogens versus only 3.3% of non-CAUTI pathogens.
There were no significant differences in antimicrobial resistance profiles within the CAUTI group when comparing hospital-acquired and community-acquired infections among CAUTI patients.
Culture before treatment
“CAUTI pathogens were more often resistant to recommended empirical antibiotics than non-CAUTI pathogens,” the researchers stated. “This finding emphasizes the need for urine sampling for culturing before initiating therapy for CAUTI and the importance of considering therapeutic alternatives.”
The study was published in Antimicrobial Stewardship & Healthcare Epidemiology.
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