Single-hospital ICU study links catheter infections to 65.1% mortality

A five-year retrospective cohort study of 107 catheter-associated urinary tract infection episodes in 98 intensive care patients found an in-hospital mortality of 65.1% and extensive carbapenem resistance among the bacterial isolates. Researchers analysed infections identified between 1 January 2021 and 31 December 2025 in the critical-care units of a training and research hospital. Episodes were detected through a national healthcare-associated infection surveillance network using definitions adapted from Centers for Disease Control and Prevention and National Healthcare Safety Network criteria.

The study reported a CAUTI incidence of 1.09 episodes per 1,000 urinary-catheter-days and a catheter utilisation ratio of 0.97. Microbiological analysis found that 99.1% of isolates were Gram-negative. Klebsiella pneumoniae accounted for 40.2% of isolates, Acinetobacter baumannii for 18.7% and Pseudomonas aeruginosa for 16.8%.

Carbapenem resistance was widespread: reported rates ranged from 94% to 97% in K. pneumoniae and were at least 94% in A. baumannii . Colistin, amikacin and ceftazidime-avibactam retained in-vitro activity against a proportion of isolates, although the number tested against some antimicrobial agents was small. These laboratory results therefore did not provide equally strong evidence for every pathogen–drug combination.

Patients who died in hospital were compared with survivors, and the researchers used Firth penalised-likelihood logistic regression to examine factors associated with in-hospital mortality. Impaired consciousness was independently associated with death, with an adjusted odds ratio of 6.60, a 95% confidence interval of 2.25–19.39 and a p-value of 0.001. The model’s discrimination was assessed with the area under the receiver-operating-characteristic curve, which was 0.769 and described as acceptable.

The results show an association, not evidence that impaired consciousness caused death; critical illness severity was also linked to the high mortality reported by the investigators. The findings are limited by the single-hospital setting, the retrospective design and the modest cohort of 98 patients, which may not represent infections or resistance patterns in other hospitals or countries. The study nevertheless provides a detailed account of pathogens and susceptibility patterns among ICU patients with CAUTI.

Its central result is that infections in this cohort were dominated by Gram-negative organisms, including K. pneumoniae , A. baumannii and Pseudomonas aeruginosa , that carbapenem resistance was extensive among the leading pathogens, and that the observed in-hospital mortality was high.

Subject of Research: Incidence, microbiology, antimicrobial resistance and mortality in ICU catheter-associated urinary tract infections

Article Title: Catheter-associated urinary tract infections in the intensive care setting: a five-year surveillance, microbiological and antibiotic-resistance study

Article References: Yetişgen, A., Kurt, O., & Erdoğan, E. (2026). Catheter-associated urinary tract infections in the intensive care setting: a five-year surveillance, microbiological and antibiotic-resistance study. BMC Infectious Diseases. https://doi.org/10.1186/s12879-026-14418-9

Image Credits: AI Generated

DOI: 10.1186/s12879-026-14418-9

Keywords: catheter-associated urinary tract infection, intensive care unit, antimicrobial resistance, carbapenem resistance, Gram-negative bacteria, healthcare-associated infection, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, in-hospital mortality, Catheter-associated, urinary