Risk factors for urinary catheter associated bloodstream infection

Bursle, Evan C., Dyer, Jane, Looke, David F. M., McDougall, David A. J., Paterson, David L. and Playford, E. G. (2015) Risk factors for urinary catheter associated bloodstream infection. Journal of Infection, 70 6: 585-591. doi:10.1016/j.jinf.2015.01.001


Author Bursle, Evan C.
Dyer, Jane
Looke, David F. M.
McDougall, David A. J.
Paterson, David L.
Playford, E. G.
Title Risk factors for urinary catheter associated bloodstream infection
Journal name Journal of Infection   Check publisher's open access policy
ISSN 1532-2742
0163-4453
Publication date 2015-06-01
Year available 2015
Sub-type Article (original research)
DOI 10.1016/j.jinf.2015.01.001
Open Access Status Not yet assessed
Volume 70
Issue 6
Start page 585
End page 591
Total pages 7
Place of publication London, United Kingdom
Publisher W.B. Saunders
Language eng
Subject 2726 Microbiology (medical)
2725 Infectious Diseases
Abstract Objectives: Urinary catheter associated bloodstream infection (UCABSI) causes significant morbidity, mortality and healthcare costs. We aimed to define the risk factors for UCABSI. Methods: A case-control study was conducted at two Australian tertiary hospitals. Patients with urinary source bloodstream infection associated with an indwelling urinary catheter (IDC) were compared to controls with an IDC who did not develop urinary source bloodstream infection. Results: There were 491 controls and 67 cases included in the analysis. Independent statistically significant risk factors for the development of UCABSI included insertion of the catheter in operating theatre, chronic kidney disease, age-adjusted Charlson comorbidity index, accurate urinary measurements as reason for IDC insertion and dementia. IDCs were inserted for valid reasons in nearly all patients, however an appropriate indication at 48hpost-insertion was found in only 44% of patients. Initial empiric antibiotics were deemed inappropriate in 23 patients (34%). Conclusion: To our knowledge, this is the first study to look specifically at the risk factors for bloodstream infection in urinary catheterised patients. Several risk factors were identified. IDC management and empiric management of UCABSI could be improved and is likely to result in a decreased incidence of infection and its complications.
Formatted abstract
Objectives

Urinary catheter associated bloodstream infection (UCABSI) causes significant morbidity, mortality and healthcare costs. We aimed to define the risk factors for UCABSI.

Methods

A case-control study was conducted at two Australian tertiary hospitals. Patients with urinary source bloodstream infection associated with an indwelling urinary catheter (IDC) were compared to controls with an IDC who did not develop urinary source bloodstream infection.

Results

There were 491 controls and 67 cases included in the analysis. Independent statistically significant risk factors for the development of UCABSI included insertion of the catheter in operating theatre, chronic kidney disease, age-adjusted Charlson comorbidity index, accurate urinary measurements as reason for IDC insertion and dementia. IDCs were inserted for valid reasons in nearly all patients, however an appropriate indication at 48 h post-insertion was found in only 44% of patients. Initial empiric antibiotics were deemed inappropriate in 23 patients (34%).

Conclusion

To our knowledge, this is the first study to look specifically at the risk factors for bloodstream infection in urinary catheterised patients. Several risk factors were identified. IDC management and empiric management of UCABSI could be improved and is likely to result in a decreased incidence of infection and its complications.
Keyword Urinary tract infection
Bacteriuria
Bloodstream infection
Urinary catheter
Bacteraemia
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: UQ Centre for Clinical Research Publications
Official 2016 Collection
School of Medicine Publications
 
Versions
Version Filter Type
Citation counts: TR Web of Science Citation Count  Cited 4 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 5 times in Scopus Article | Citations
Google Scholar Search Google Scholar
Created: Tue, 03 Feb 2015, 10:49:18 EST by System User on behalf of School of Medicine