Frequency of catheter associated urinary tract infections in PICU of NICH, Karachi, Pakistan.

Abstract

Objective: To determine the frequency of catheter associated urinary tract infections (CAUTI) in children admitted to pediatric intensive care unit (PICU). Study Design: Cross-sectional study. Setting: The PICU of National Institute of Child Health, Karachi, Pakistan. Period: 10^th July 2025 to 25^th November 2025. Methods: A total of 158 children aged 1 month to 12 years who underwent urinary catheterization for ≥1 week were enrolled through consecutive sampling. Demographic and clinical data, catheter duration, and outcomes were recorded. Data were analyzed using SPSS v26.0, applying chi-square, Fisher’s exact, t-test, or Mann–Whitney U test, with p<0.05 considered significant. Results: Among 158 children, 92 (58.2%) were males, and 66 (41.8%) females, with a median age of 3.4 years (IQR 1.2–7.8). Respiratory diseases were observed in 104 (65.8%), neurological disorders in 22 (13.9%), and cardiac disorders in 16 (10.1%). CAUTI developed in 31 (19.6%) children after a median of 10 days (IQR 9–13). Malnutrition (22.6% vs. 8.7%, p=0.029). and sepsis (19.4% vs. 6.3%, p=0.022) were significantly associated. E. coli (45.2%), and K. pneumoniae (29.0%) were common isolates with highest sensitivity to meropenem (80.6%) and resistance to ciprofloxacin (71.0%). CAUTI cases had longer catheterization (12.7 vs. 9.2 days, p<0.001), PICU stay (14.2 vs. 10.5 days, p=0.004), and higher mortality (35.5% vs. 16.5%, p<0.001). Conclusion: Catheter-associated urinary tract infection was identified in nearly one-fifth of critically ill children admitted to the PICU. Prolonged catheterization, malnutrition, systemic infection, and mechanical ventilation significantly increased CAUTI risk.