Abstract

Background: Catheter-associated urinary tract infections (CAUTIs) represent one of the most common healthcare-associated infections, often caused by multidrug-resistant organisms. This study aimed to investigate the etiological profile, antimicrobial resistance patterns, and risk factors of CAUTIs among patients admitted to a therapeutic department. Methods: A retrospective-prospective comparative observational study was conducted at the Grodno University Clinic from January 2024 to September 2025. A total of 200 patients with confirmed urinary tract infections were included: 100 with urinary catheters and 100 without. Microbiological cultures and antibiotic susceptibility testing were performed according to CLSI (2023) standards. Statistical analyses included χ² and t-tests; logistic regression was applied to identify independent risk factors for multidrug-resistant infection. A p-value of <0.05 was considered statistically significant. Results: Escherichia coli was the predominant pathogen in both groups, but its frequency was significantly lower among catheterized patients (34% vs. 56%, p=0.003). Klebsiella pneumoniae and Pseudomonas aeruginosa were more common in catheterized individuals. Catheter-associated isolates showed higher resistance to ampicillin (82% vs. 58%), ciprofloxacin (46% vs. 28%), and a greater prevalence of ESBL-producing strains (38% vs. 20%). Multidrug resistance was detected in 48% of isolates from catheterized patients compared with 27% in non-catheterized cases (p<0.01). Catheterization and prior antibiotic exposure were independent predictors of MDR infection. Conclusion: Urinary catheterization substantially increases the risk of infection by multidrug-resistant and ESBL-producing pathogens. Continuous surveillance, rational antibiotic use, and minimizing catheter duration are essential to reduce the burden of CAUTIs and improve patient outcomes.

Keywords

catheter-associated urinary tract infection, antimicrobial resistance, escherichia coli, klebsiella pneumoniae, extended-spectrum b-lactamase, multidrug resistance, infection prevention, hospital epidemiology