Catheter-associated urinary tract infections (CAUTI) are common worldwide, but due to limited resources, its actual burden in low-income countries is unknown. Currently, there are gaps in knowledge about CAUTI due to lack of surveillance activities in Sierra Leone. In this prospective cohort study, we aimed to determine the incidence of CAUTI and associated antibiotic resistance in two tertiary hospitals in different regions of Sierra Leone.
The mean age of the 459 recruited patients was 48.8 years. The majority were females (236, 51.3%). Amongst the 196 (42.6%) catheterized patients, 29 (14.8%) developed CAUTI. Bacterial growth was reported in 32 (84%) patients. Escherichia coli (14, 23.7%), Klebsiella pneumoniae (10, 17.0%), and Klebsiella oxytoca (8, 13.6%) were the most common isolates. Most isolates were ESBL-producing Enterobacteriaceae (33, 56%) and WHO Priority 1 (Critical) pathogens (38, 71%). Resistance of K. pneumoniae, K. oxytoca, E. coli, and Proteus mirabilis was higher with the third-generation cephalosporins and penicillins but lower with carbapenems, piperacillin-tazobactam and amikacin. To reduce the high incidence of CAUTI and multi-drug resistance organisms, urgent action is needed to strengthen the microbiology diagnostic services and develop and implement catheter bundles that provide clear guidance for catheter insertion, care and removal.
BMC research notes. 2023 Oct 31*** epublish ***
Sulaiman Lakoh, Le Yi, James B W Russell, Juling Zhang, Stephen Sevalie, Yongkun Zhao, Joseph Sam Kanu, Peng Liu, Sarah K Conteh, Christine Ellen Elleanor Williams, Umu Barrie, Olukemi Adekanmbi, Darlinda F Jiba, Matilda N Kamara, Daniel Sesay, Gibrilla F Deen, Joseph Chukwudi Okeibunor, George A Yendewa, Xuejun Guo, Emmanuel Firima
College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone. ., Tropical Infectious Disease Prevention and Control Center, Freetown, Sierra Leone., College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone., Department of Clinical Laboratory, the Fifth Medical Center of Chinese PLA General Hospital, Beijing, 100039, China., Department of Emergency Medicine, the Fifth Medical Center of Chinese PLA General Hospital, Beijing, 100039, China., Ministry of Health and Sanitation, Government of Sierra Leone, Freetown, Sierra Leone., Infectious Disease Research Network, Freetown, Sierra Leone., Department of Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria., World Health Organization Regional Office for Africa, Brazzaville, Congo., Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, OH, USA., Tropical Infectious Disease Prevention and Control Center, Freetown, Sierra Leone. ., Clinical Research Unit, Department of Medicine, Swiss Tropical and Public Health Institute, Basel, Switzerland.