Abstract
Introduction: Nosocomial urinary tract infections (UTIs), particularly catheter-associated urinary tract infections (CAUTIs), remain as one of the most common complications of hospitalization. Recent evidence suggests a shift in pathogen profiles, including a growing contribution of fungal organisms, alongside increasing prevalence of antimicrobial resistance among bacterial isolates.
Methods: We conducted a retrospective cross-sectional study over one year (March 2024–February 2025) in a tertiary hospital in western Tehran. Symptomatic CAUTI cases with positive urine culture≥48 hours after admission were included. Demographic and clinical data, ward distribution, microbiological findings, time-to-infection measures, and in-hospital outcome were extracted from medical records and the hospital information system.
Results: Most cases were identified in intensive care units and the mortality rate of the CAUTI population was 41.9% (113/270). The dominant pathogen was Candida spp. (53%, 143/270). Second most frequently isolated organisms were Klebsiella spp. (18.5%, 50/270), followed by E. coli (13.3%, 36/270), and Enterococcus spp. (9.25%, 25/270). Analyses of antimicrobial susceptibility showed high resistance rates among Klebsiella spp. and E. coli isolates, particularly to cephalosporins and fluoroquinolones, as well as notable carbapenem resistance.
Conclusion: These findings highlight the importance of monitoring catheter-associated urinary tract infection in hospitalized patients and appropriate antibiotic prescribing based on antibiogram results. Additionally, it is necessary to study the antibiogram test for Candida spp. because it was the predominant pathogen in this hospital.