Sustainability of a program for continuous reduction of catheter-associated urinary tract infection

Urinary tract infections account for 8%-21% of health care-associated infections; of these, 80% are associated with the use of a urinary catheter.

A quasi-experimental study was conducted in 2 medical-surgical intensive care units (ICUs) with 48 beds and 3 step-down units (SDUs) with 95 beds in a private tertiary care hospital in Sao Paulo, Brazil.

The study had 3 phases over a 9-year period to determine the sustainability of a program for continuous reduction of catheter-associated urinary tract infection (CAUTI).

Over the 3 phases of the study, rates of CAUTI in the ICUs fell from 7. 0 to 3. 5 to 0. 9 infections per 1,000 catheter days. In the SDUs, CAUTI rates decreased from 14. 9 to 6. 6 to 1. 0 per 1,000 catheter days. Comparisons of CAUTI rates in the 3 study phases, both in the ICUs and SDUs, showed significant reductions both between the 3 periods and in all possible combinations of analysis phases (all P < . 001).

These results suggest that it is possible to reduce CAUTI rates to near zero and sustain these rates, but it requires a multidisciplinary team with different strategies that require continuous monitoring.

American journal of infection control. 2016 Jan 29 [Epub ahead of print]

Dejanira A Regagnin, Debora Schettini da Silva Alves, Ana Maria Cavalheiro, Thiago Zinsly Sampaio Camargo, Alexandre R Marra, Elivane da Silva Victor, Michael B Edmond

Intensive Care Unit, Hospital Israelita Albert Einstein, São Paulo, Brazil. , Intensive Care Unit, Hospital Israelita Albert Einstein, São Paulo, Brazil. , Intensive Care Unit, Hospital Israelita Albert Einstein, São Paulo, Brazil. , Intensive Care Unit, Hospital Israelita Albert Einstein, São Paulo, Brazil. , Division of Medical Practice, Hospital Israelita Albert Einstein, São Paulo, Brazil. Instituto Israelita de Ensino e Pesquisa Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, Brazil. , Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA.

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