BACKGROUND: Traditional methods of surveillance of catheter-associated urinary tract infections (CAUTIs) are error-prone and resource-intensive.
To resolve these issues, we developed a highly sensitive electronic surveillance tool.
OBJECTIVE: To develop an electronic surveillance tool for CAUTIs and assess its performance.
METHODS: The study was conducted at a 947-bed tertiary care center. Patients included adults aged ≥18 years admitted to an intensive care unit between January 10 and June 30, 2012, with an indwelling urinary catheter during their admission. We identified CAUTIs using 4 methods: traditional surveillance (TS) (ie, manual chart review by ICPs), an electronic surveillance (ES) tool, augmented electronic surveillance (AES) (ie, ES with chart review on a subset of cases), and reference standard (RS) (ie, a subset of CAUTIs originally ascertained by TS or ES, confirmed by review). We assessed performance characteristics to RS for reviewed cases.
RESULTS: We identified 417 candidate CAUTIs in 308 patients; 175 (42.0%) of these candidate CAUTIs were selected for review, yielding 32 confirmed CAUTIs in 22 patients (RS). Compared with RS, the sensitivities of TS, ES, and AES were 43.8% (95% confidence interval [CI], 26.4%-62.3%), 100.0% (95% CI, 89.1%-100.0%), and 100.0% (95% CI, 89.1%-100.0%). Specificities were 82.5% (95% CI, 75.3%-88.4%), 2.8% (95% CI, 0.8%-7.0%), and 100.0% (95% CI, 97.5%-100.0%).
CONCLUSIONS: Electronic CAUTI surveillance offers a streamlined approach to improve reliability and resource burden of surveillance.
Hsu HE, Shenoy ES, Kelbaugh D, Ware W, Lee H, Zakroysky P, Hooper DC, Walensky RP. Are you the author?
Institution(s): See publishing journal.
Reference: Am J Infect Control. 2015 Mar 31. pii: S0196-6553(15)00115-7.