Catheter-associated urinary tract infections in urethral stricture patients indwelling suprapubic catheter: Insights from a retrospective investigation into specific antibiogram and risk factors

This is the authors' abstract. We don't add key points for this paper.

OBJECTIVES: This study aimed to evaluate the incidence and risk factors of suprapubic catheter-associated bacteriuria (SPCAB) and multidrug-resistant bacteria (MDRB) in patients with urethral strictures, and compare antimicrobial resistance patterns between pathogens isolated from urinary samples and suprapubic catheters. METHODS: A retrospective analysis was performed on patients with urethral strictures who had urethral reconstructive surgery with suprapubic catheters from January 2010 to June 2023. Clinical data, bacterial pathogens, and resistance patterns were collected. Heatmaps visualized resistance profiles. Descriptive statistics summarized demographics and perioperative variables; while binary logistic regression models were applied to identify independent risk factors for SPCAB and MDRB. RESULTS: Among 2809 urine samples, 42.6 % yielded positive cultures. The predominant pathogens in SPCAB were Escherichia coli (18.8 %) and Pseudomonas aeruginosa (11.9 %). Common pathogens exhibited high antimicrobial resistance rates, mirroring patterns observed in suprapubic catheter isolates. Risk factors for SPCAB included duration after suprapubic cystostomy (OR=1.712, P = 0.049), indwelling time of single catheter >15 days (OR=2.870, P = 0.007), absence of catheter colonization (OR=0.079, P < 0.001), and antibiotic use >7 days. For MDRB, significant risk factors comprised duration after suprapubic cystostomy (OR=2.014, P = 0.009), indwelling time of single catheter >30 days (OR=2.541, P = 0.019), absence of MDRB colonization (OR=0.079, P < 0.001), and postoperative sampling. CONCLUSIONS: In managing urethral strictures with SPCs, our findings emphasize prioritizing perioperative strategies: early catheter replacement (≤15-day intervals), empirical antimicrobial therapy guided by local resistance patterns. SPC culture-guided interventions may hold potential clinical value for mitigating SPCAB risks, though further validation is warranted.