An international prospective study of INICC analyzing the incidence and risk factors for catheter-associated urinary tract infections in 235 ICUs across 8 Asian Countries.
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Rosenthal Victor D, Yin Ruijie, Abbo Lilian M, Lee Brandon H, Rodrigues Camilla, Myatra Sheila N, Divatia Jigeeshu V, Kharbanda Mohit, Nag Bikas, Rajhans Prasad, Shingte Vasudha, Mehta Yatin, Sarma Smita, Todi Subhash K, Bhattacharyya Mahuya, Basu Sushmita, Sahu Suneeta, Mishra Shakti B, Samal Samir, Chawla Rajesh, Jain Aakanksha C, Nair Pravin K, Kalapala Durga, Arjun Rajalakshmi, Singla Deepak, Sandhu Kavita, Badyal Binesh, Palaniswamy Vijayanand, Bhakta Arpita, Gan Chin S, Mohd-Basri Mat N, Lai Yin H, Tai Chian-Wern, Lee Pei-Chuen, Bat-Erdene Ider, Begzjav Tsolmon, Acharya Subhash P, Dongol Reshma, Ikram Aamer, Tumu Nellie, Tao Lili, Jin Zhilin
Аннотация
METHODS: From January 1, 2014, to February 12, 2022, we conducted a prospective cohort study. To estimate CAUTI incidence, the number of UC days was the denominator, and CAUTI was the numerator. To estimate CAUTI RFs, we analyzed 11 variables using multiple logistic regression.
RESULTS: 84,920 patients hospitalized for 499,272 patient days acquired 869 CAUTIs. The pooled CAUTI rate per 1,000 UC-days was 3.08; for those using suprapubic-catheters (4.11); indwelling-catheters (2.65); trauma-ICU (10.55), neurologic-ICU (7.17), neurosurgical-ICU (5.28); in lower-middle-income countries (3.05); in upper-middle-income countries (1.71); at public-hospitals (5.98), at private-hospitals (3.09), at teaching-hospitals (2.04). The following variables were identified as CAUTI RFs: Age (adjusted odds ratio [aOR] = 1.01; 95% CI = 1.01-1.02; P < .0001); female sex (aOR = 1.39; 95% CI = 1.21-1.59; P < .0001); using suprapubic-catheter (aOR = 4.72; 95% CI = 1.69-13.21; P < .0001); length of stay before CAUTI acquisition (aOR = 1.04; 95% CI = 1.04-1.05; P < .0001); UC and device utilization-ratio (aOR = 1.07; 95% CI = 1.01-1.13; P = .02); hospitalized at trauma-ICU (aOR = 14.12; 95% CI = 4.68-42.67; P < .0001), neurologic-ICU (aOR = 14.13; 95% CI = 6.63-30.11; P < .0001), neurosurgical-ICU (aOR = 13.79; 95% CI = 6.88-27.64; P < .0001); public-facilities (aOR = 3.23; 95% CI = 2.34-4.46; P < .0001).
DISCUSSION: CAUTI rate and risk are higher for older patients, women, hospitalized at trauma-ICU, neurologic-ICU, neurosurgical-ICU, and public facilities. All of them are unlikely to change.
CONCLUSIONS: It is suggested to focus on reducing the length of stay and the Urinary catheter device utilization ratio, avoiding suprapubic catheters, and implementing evidence-based CAUTI prevention recommendations.