An electronic surveillance tool for catheter-associated urinary tract infection in intensive care units - Abstract

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.

Written by:
Hsu HE, Shenoy ES, Kelbaugh D, Ware W, Lee H, Zakroysky P, Hooper DC, Walensky RP.   Are you the author?
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Reference: Am J Infect Control. 2015 Mar 31. pii: S0196-6553(15)00115-7.
doi: 10.1016/j.ajic.2015.02.019

PubMed Abstract
PMID: 25840717