A retrospective study of hospital patients with catheter-associated asymptomatic bacteriuria (CA-ASB) caused by multidrug-resistant Pseudomonas aeruginosa (MDRP) found that antibiotic treatment was a significant risk factor for subsequent infection, researchers reported in the American Journal of Infection Control.
The study, conducted by researchers in South Korea, found that, among 139 hospitalized patients with MDRP CA-ASB at a tertiary hospital in 2018, subsequent MDRP infections were observed in 37 (26.6%), including urinary tract infections (17.3%), pneumonia (4.3%), soft-tissue infection (3.6%), and bone and joint infection (1.4%). Of the 139 patients, 12 received active antibiotic treatment for MDRP and 60 received non-active antibiotic treatment.Â
Multivariate analysis showed that underlying urologic disease (hazard ratio (HR), 2.17; 95% confidence interval [CI], 1.01 to 4.66), active antibiotic treatment (HR, 2.34; 95% CI, 1.02 to 5.38), and recurrent bacteriuria (HR, 3.57; 95% CI, 1.73 to 7.38) were subsequent symptomatic infections.
Guidelines don’t recommend antibiotic treatment
The authors note that while patients with catheters are frequent ASB carriers, antibiotic treatment has shown no clear benefits for patients with CA-ASB and can contribute to antimicrobial resistance and lead to adverse effects, which is why current guidelines do not recommend antibiotics for the condition. Still, the rate of antibiotic treatment for CA-ASB remains high.Â
“Our findings strongly support adherence to the current guidelines that recommend against antibiotic therapy for CA-ASB, despite the involvement of multidrug-resistant pathogens such as MDRP,” they wrote. “We believe the findings will contribute to more informed decision-making by clinicians regarding antibiotic use in patients with MDRP CA-ASB, thereby potentially reducing unnecessary treatments while ensuring timely intervention for high-risk patients.”
