High proportion of healthcare-associated urinary tract infection in the absence of prior exposure to urinary catheter: a cross-sectional study

Antimicrobial Resistance and Infection Control

Ilker Uçkay⁹  Hugo Sax²  Angèle Gayet-Ageron⁴  Christian Ruef³  Kathrin Mühlemann¹  Nicolas Troillet⁶  Christiane Petignat¹⁰  Enos Bernasconi⁸  Carlo Balmelli¹⁰  Andreas Widmer⁵  Karim Boubaker⁷  Didier Pittet⁹ 

[1] Department of Infectious Diseases, University Hospital Bern, Bern, Switzerland

[2] Current addresses: Department of Infectious Diseases and Hospital Hygiene, University of Zurich, Zurich, Switzerland

[3] Division of Infectious Diseases, University Hospital of Zurich, Zurich, Switzerland

[4] Infection Control Programme and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, 4 Rue Gabrielle Perret-Gentil, 1211, Geneva 14, Switzerland

[5] Division of Infectious Diseases, University of Basel Hospitals, Basel, Switzerland

[6] Department of Infectious Diseases, Central Institute of the Valais Hospitals, Sion, Switzerland

[7] Current addresses: Public Health Service for the Canton of Vaud, Lausanne, Switzerland

[8] Department of Infectious Diseases, Ospedale Civico, Lugano, Switzerland

[9] Department of Infectious Diseases, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland

[10] Department of Hospital Preventive Medicine, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland

关键词: Risk factors;    Nosocomial;    Urinary tract infection;    Acute care;    Urinary catheter;    Prevalence;   

Others  :  790955
DOI  :  10.1186/2047-2994-2-5

 received in 2012-10-09, accepted in 2013-01-14,  发布年份 2013

【 摘 要 】

Background

Exposure to urinary catheters is considered the most important risk factor for healthcare-associated urinary tract infection (UTI) and is associated with significant morbidity and substantial extra-costs. In this study, we assessed the impact of urinary catheterisation (UC) on symptomatic healthcare-associated UTI among hospitalized patients.

Methods

A nationwide period prevalence survey of healthcare-associated infections was conducted during 1 May to 30 June 2004 in 49 Swiss hospitals and included 8169 adult patients (4313 female; 52.8%) hospitalised in medical, surgical, intermediate, and intensive care wards. Additional data were collected on exposure to UC to investigate factors associated with UTI among hospitalised adult patients exposed and non-exposed to UC.

Results

1917 (23.5%) patients were exposed to UC within the week prior to survey day; 126 (126/8169; 1.5%) developed UTI. Exposure to UC preceded UTI only in 73 cases (58%). By multivariate logistic regression analysis, UTI was independently associated with exposure to UC (odds ratio [OR], 3.9 [95% CI, 2.6-5.9]), female gender (OR, 2.1 [95% CI, 1.4-3.1]), an American Society of Anesthesiologists’ score > 2 points (OR, 3.2 [95% CI, 1.1-9.4], and prolonged hospital stay >20 days (OR, 1.9 [95% CI, 1.4-3.2]. Further analysis showed that the only significant factor for UTI with exposure to UC use was prolonged hospital stay >40 days (OR, 2.9 [95% CI, 1.3-6.1], while female gender only showed a tendency (OR, 1.6 [95% CI, 1.0-2.7]. In the absence of exposure to UC, the only significant risk factor for UTI was female gender (OR, 3.3 [95% CI, 1.7-6.5]).

Conclusions

Exposure to UC was the most important risk factor for symptomatic healthcare-associated UTI, but only concerned about half of all patients with UTI. Further investigation is warranted to improve overall infection control strategies for UTI.

【 授权许可】

   
2013 Uçkay et al; licensee BioMed Central Ltd.

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