Risk Factors and Outcomes of Catheter-Associated Urinary Tract Infections in the Intensive Care Unit of a Tertiary University Hospital: A Prospective Study.

BACKGROUND

Catheter-associated urinary tract infections (CAUTIs) are common among patients admitted to the intensive care unit (ICU). ICU-related CAUTI is associated with longer hospital stays, greater financial burden, greater antibiotic use and impact on mortality.

AIM: This study aimed to address the incidence and risk factors, causative pathogens and outcomes of CAUTI among patients admitted to the ICU of a tertiary University Hospital.

STUDY

DESIGN

This is a prospective study. All adult patients admitted to the ICU of a University Hospital who had indwelling urinary catheters (IUCs) at admission were included. Based on the occurrence of CAUTI, the study cohorts were divided into two groups: those with CAUTI and those without CAUTI. The incidence, risk factors, causative pathogens and the outcomes of patients with CAUTI were addressed.

RESULTS

One hundred and forty patients were enrolled, with a mean age of 43.84 ± 13.86 years, and 69/140 (49.3%) were male. The incidence of CAUTI was 43.5. CAUTI were significantly related to older age, female sex, smoking, post-surgery, diabetes mellitus (DM), obstructive uropathy, immobility, faecal incontinence and the duration of urinary catheterisation. Cox regression analysis revealed that the most significant risk factors for CAUTI were the duration of urinary catheterisation, DM and post-surgery, with hazard ratio of 7.14, 95% confidence interval (CI) 3.78-14.63, p < 0.001, 6.25, 95% CI 3.13-11.47, p < 0.001 and 2.34, 95% CI 1.23-4.45, p = 0.010, respectively.

CONCLUSIONS

The current study shows that the incidence of CAUTI among ICU patients is high. Numerous risk factors for CAUTI were identified and included older age, female sex, longer duration of catheterisation, smoking, post-surgery, DM, obstructive uropathy and immobility. The most significant risk factors for CAUTI were the duration of urinary catheterisation, DM and post-surgery. Special precautions are needed to prevent CAUTI among ICU patients with those risk factors.

RELEVANCE TO CLINICAL PRACTICE: The results of this study will have implications for daily ICU practice. It is important to identify high-risk patients and consider targeted preventive measures. Ongoing education for healthcare workers on CAUTI prevention and management should be taken into account.