Comparative Study of Bacterial Isolation and Antibiotic Sensitivity Test of Urine and Catheter-tip Culture in Long-term Catheter Indwelling Patients

Shin, Dong Shin; Suh, Suk Ho; Choi, Nak Gyeu

Abstract

Urinary tract infections constitute a large clinical problems that particularly affect catheter indwelling patients, causing morbidity and mortality. To investigate 1) the rate of infection by duration of catheter indwelling in patients of several kinds of disease, 2) the kinds of colonized bacteria and the similarity or difference of the bacterial species cultured in the urine and catheter of same patient, and 3) the comparison of sensitivity to antibiotics of cultured bacteria of both material, bacterial culture and antibiotic sensitivity test were done from urine and proximal tip of catheters in 31 catheter indwelling patients who had been administered, sometimes intermittently, various antibiotics. The rate of bacterial infection increased markedly with the lengthening of catheter indwelling period in urine and catheter cultures, 22.2% and 33.3% at 1 week, both 50% at 2-3 weeks, 78.6% and 85.7% at 4 weeks respectively The results of bacterial culture from both material were same in 27 (87.1%) patients. The gram negative bacteria composed of 41 (89.1%) species in cultured bacteria. The three frequent species were 16 (34.8%) Escherichia coli, 9 (19.6%) Klebsiella pneumonia, and 6 (13.0%) Morganella morgagni. The overall sensitivity of urine cultured bacteria to tested antibiotics showed minor difference from that of catheter, susceptible in 70.4%, and 73.8%, resistant in 28. 6%, and 24.6%, respectively. Almost all of the patients indwelling catheter longer than 4 weeks had bacterial infection or colonization in urine and proximal catheter-tip in spite of preventive administration of antibiotics. The urine culture only may be enough instead of culturing both the urine and proximal catheter-tip in long-term catheterized patients. Routine antibacterial drug administration should be taken into consideration not to be overused in long-term catheter indwelling patients.