TY - JOUR
T1 - Catheter-associated urinary tract infection: Role of the setting of catheter insertion
AU - Barbadoro, Pamela
AU - Labricciosa, Francesco M.
AU - Recanatini, Claudia
AU - Gori, Giada
AU - Tirabassi, Federico
AU - Martini, Enrica
AU - Gioia, Maria Grazia
AU - D'Errico, Marcello M.
AU - Prospero, Emilia
N1 - Publisher Copyright:
Copyright © 2015 by the Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
PY - 2015/7/1
Y1 - 2015/7/1
N2 - 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.
AB - 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.
KW - Catheter-associated urinary tract infection
KW - Health care-associated infection
KW - Risk factor
KW - Surveillance
UR - http://www.scopus.com/inward/record.url?scp=84937521973&partnerID=8YFLogxK
U2 - 10.1016/j.ajic.2015.02.011
DO - 10.1016/j.ajic.2015.02.011
M3 - Article
C2 - 25840715
AN - SCOPUS:84937521973
SN - 0196-6553
VL - 43
SP - 707
EP - 710
JO - American journal of infection control
JF - American journal of infection control
IS - 7
ER -