Catheter-associated urinary tract infection: Role of the setting of catheter insertion - Abstract

BACKGROUND: This study aimed to describe the epidemiology of catheter-associated urinary tract infections (CAUTIs) in patients admitted to a surgical ward in Central Italy and to analyze the associated risk factors.

METHODS: An active surveillance program for CAUTI was carried out in patients catheterized for at least 48 hours. Place of catheter insertion (operating room, hospital ward, cystoscopy room, emergency care unit), indication for catheterization and its duration, among other risk factors were monitored until discharge. Antibiotic resistance profiles of isolates were analyzed.

RESULTS: There were 641 catheterized patients monitored for CAUTI onset. Of these, 40 (6.2%) developed a CAUTI (rates were 15.1/1,000 catheter days, 95% confidence interval [CI], 11.9-22.6; 8.7/1,000 patient days, 95% CI, 6.9-13.1). Patients with CAUTI were older (P < .05) and their durations of hospitalization and catheterization were both longer compared with those who were not affected (P < .05). Catheterization >4 days (odds ratio [OR] = 8.21; 95% CI, 3.79-17.73; P < .05) and place of catheter insertion different from the operating room (OR = 7.9; 95% CI, 2.83-22.08; P < .05, for catheters placed in the ward) were associated with CAUTI. Among the micro-organisms isolated in CAUTIs, the most common were Pseudomonas aeruginosa (41.5%), Klebsiella pneumoniae (19.5%), and Escherichia coli (12.2%); 82.5% of them were resistant to different classes of antibiotics.

CONCLUSION: These results highlight the role played by the setting of catheter insertion in CAUTIs onset, therefore reflecting the importance of hand hygiene and proper aseptic insertion techniques as crucial determinants in CAUTIs prevention.

Written by:
Barbadoro P, Labricciosa FM, Recanatini C, Tirabassi F, Martini E, Gioia MG, D'Errico MM, Prospero E, Gori G.   Are you the author?
Department of Biomedical Sciences and Public Health, Unit of Hygiene, Preventive Medicine and Public Health, Università Politecnica delle Marche, Ancona, Italy; Services Department, Hospital Hygiene Unit, Azienda Ospedaliero Universitaria Ospedali Riuniti, Ancona, Italy; Services Department, Hospital Hygiene Unit, Azienda Ospedaliero Universitaria Ospedali Riuniti, Ancona, Italy.  

Reference: Am J Infect Control. 2015 Mar 31. pii: S0196-6553(15)00107-8.
doi: 10.1016/j.ajic.2015.02.011


PubMed Abstract
PMID: 25840715

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