PP 7 - Catheter-associated urinary tract infections (CAUTIs) among medical and surgical ward patients in a base hospital in the Western Provincepital in the Western province

Ranasinghe RATK¹, Adikari AMDR², Priyangika JMU² , ¹University of Sri Jayewardenepura, ²Colombo East Base Hospital

Abstract

Introduction

Monitoring CAUTI is a vital component of infection prevention and quality improvement in the healthcare sector.

Objectives

To identify the prevalence of urinary catheter use, determine the proportion of CAUTIs in medical and surgical wards, and assess compliance with infection prevention protocols.

 Design, setting, and methods

A point prevalence study was conducted in June 2025, using a structured data collection tool in the medical and surgical wards of Colombo-East Base Hospital. Urine culture results were obtained from the microbiology laboratory.

Results

A total of 13.5% (35/259) of patients were catheterised, including 16% (28/175) from medical wards and 8.3% (7/84) from surgical wards. The main indications for catheterisation were critical illness (37.1%, n=13) and urinary incontinence (25.7%, n=9). In 28.6% (n=10), fluid balance monitoring was the sole indication.

Urine culture results were available for 18 patients. Overall, 20% (7/35) of catheterised patients had positive urine cultures while 8.5% (3/35) showed mixed growth. However, CAUTI was diagnosed only in 5.7% (n=2) of patients.

The duration of catheterisation was 2-7 days in 62.9% (22/35), 8-14 days in 25.7% (9/35), and more than 14 days in 11.4% (4/35). Both CAUTI cases occurred in patients with a catheter duration of 8-14 days.

Satisfactory catheter securement was maintained in 91.4% (32/35) of patients. Proper drainage bag maintenance was observed in 85.7% (30/35). Unobstructed urine flow and maintenance of a closed drainage system were observed in all patients. Daily perineal care was performed in all catheterised patients. Among 68.6% (24/35) of patients who had bystanders, only 41.6% (10/24) received education on proper catheter care.

Conclusions

Overall, satisfactory adherence to infection control guidelines was observed, particularly in catheter maintenance practices. However, inappropriate indications such as catheterisation solely for fluid monitoring and gaps in bystander education highlight areas for improvement. The findings of this study, with a CAUTI rate of 5.7%, indicate that opportunities remain to optimise catheter utilisation practices and improve education on catheter care.