Comparative Evaluation of Conventional Methods and Matrix-Assisted Laser Desorption/Ionization Time-of-Flight Mass Spectrometry (MALDI-TOF MS) for Uropathogen Identification in Catheter-Associated Urinary Tract Infections in ICU Patients.

Background Catheter-associated urinary tract infections (CAUTIs) are a significant concern in ICU patients, often leading to complications such as bloodstream infections, urosepsis, prolonged hospitalization, and increased mortality, particularly due to delayed diagnosis and rising antibiotic resistance. For therapy to be effective, the causing pathogens must be identified quickly and accurately. This study compares conventional microbiological methods with Matrix-Assisted Laser Desorption/Ionization Time-of-Flight Mass Spectrometry (MALDI-TOF MS) for identifying urinary isolates in CAUTI cases and examines their antibiotic susceptibility patterns. Methods Over one year, we analyzed 780 catheterized urine samples from ICU patients at a tertiary care hospital. All samples were processed using standard culture techniques and MALDI-TOF MS for pathogen identification. Antibiotic susceptibility testing was performed according to Clinical and Laboratory Standards Institute (CLSI) guidelines. Descriptive statistics were used for data summarization, and Chi-square test assessed associations between risk factors and CAUTI occurrence, with agreement between MALDI-TOF MS and conventional identification methods evaluated by Cohen's Kappa analysis. The Chi-square test's statistical significance was set at