PURPOSE: Catheter-associated urinary tract infections (CAUTI) are an essential measure for health care quality improvement that affects reimbursement through hospital-acquired condition reduction programs in adult patients.
With the mounting importance of preventing CAUTI, we sought to evaluate risk factors for acquiring CAUTI in pediatric patients.
METHODS: All CAUTIs were identified within one pediatric institution from September 2010 to August 2014 from a prospective database maintained by the Infection Control Office. To identify risk factors, CAUTI patients were individually matched to control patients with a urinary catheter but without CAUTI by age, sex, date, and hospital location of CAUTI in a 1:2 fashion.
RESULTS: Fifty patients with CAUTI were identified and were matched to 100 control patients. Compared to control patients, CAUTI patients were more likely to have catheters in place for longer (2.9 days) (OR 1.08, 95%CI 1.01,1.15, p=0.02). They were also more likely to be on contact precautions (OR 4.00, 95%CI 1.73,9.26, p=0.001), have concurrent infections (OR 3.04, 95%CI 1.39,6.28, p=0.005) and have a history of prior catheterization (OR 3.24, 95%CI 1.55,6.77, p=0.002). Using a conditional multivariate regression model, the three most predictive variables were duration of catheter drainage, contact isolation status and history of prior catheterization.
CONCLUSIONS: Longer duration of urinary catheter drainage, positive contact precautions status, and prior history of catheterization appear to be associated with a higher risk of CAUTI in hospitalized pediatric patients. Physicians should attempt to reduce the duration of catheterization, especially in patients who meet these criteria, to minimize the risk of CAUTI.
Lee NG, Marchalik D, Lipsky A, Rushton HG, Pohl HG, Song X. Are you the author?
Division of Urology, Children's National Medical Center, Washington DC; Department of Internal Medicine, Montefiore Medical Center, New York NY; Division of Infectious Diseases, Children's National Medical Center, Washington DC.
Reference: J Urol. 2015 Apr 6. pii: S0022-5347(15)03696-4.