Catheter-associated urinary tract infections (CAUTIs) are most common type of nosocomial infection. This study was designed to recognize and identify the bacterial pathogen of catheter-associated urinary tract infection in patients, the sensitivity pattern of bacterial pathogens to commonly used antibiotics and the synergistic effect of antibiotics with ascorbic acid to improve the efficacy of antibiotics. The prospective, observational study was conducted in Sir Ganga Raam hospital Lahore. The urine samples from 100 catheterized patients were collected and were analyzed for its causative /pathogenic organism. Out of 100 patients, 58 patients carried E.coli (27%), Citrobacter (22%), Enterobacter (5%) and Staphylococcus aureus (4%) and these patients were included in study. Sensitivity patterns of Ampicillin, Co-amoxiclav, Ceftriaxone and Ciprofloxacin were checked by Kirby-Bauer disk diffusion method. Uropathogens appeared to be highly resistant against Ceftriaxone (84%), followed by Co-amoxiclave (83%) and Ampicillin (76%).Amikacin and Ciprofloxacin are effective drugs against uropathogens and their sensitivities to Amikacin and Ciprofloxacin were 74% and 71% respectively.
Susceptibility testing of bacteria against antibiotics and ascorbic acid alone and in combination was checked and it was observed that bacterial resistance to Ceftriaxone was reversed with ascorbic acid and the effectiveness of ciprofloxacin was improved with ascorbic acid. In Citrobacter, ascorbic acid antagonized the effects of Amikacin.
Empirical therapy of patients included in study was evaluated by clinical response and their definitive therapy was assessed by observing the adverse effects associated with that drug. Co-amoxiclav produced 100% side effects. Tinnitus (63%) was observed in patients treated with Amikacin while Ciprofloxacin adverse effects were headache and dizziness.
It was concluded in the study that there was high incidence of infection in catheterized patients with resistant bacteria and inappropriate antibiotic therapy. Ascorbic acid may be prescribed prophylactically to catheterized patients and to those who take Ceftriaxone to minimize its resistance in patients. To improve the effectiveness of drugs in CAUTI patients, ascorbic acid may be used with antibiotics.