Risk factors for catheter-associated urinary tract infection in an intensive care unit: a matched case-control study
Abstract
Catheter-associated urinary tract infections (CAUTIs) are common healthcare-related infections in intensive care units (ICUs). This study investigated the risk factors for CAUTIs in critically ill patients. This study was a single-centre, retrospective, matched case-control study of patients undergoing indwelling catheterization in the ICU from December 1, 2016, to October 31, 2021. Patients with catheterizations were matched 1:4 with controls that were hospitalized in the ICU during the same period (with a difference in admission time of no more than two months). CAUTI occurred in 18 of 403 patients, with an infection rate of 3.7/per 1000 catheter days. Repeat catheterization of the urinary catheter (OR = 10.09) and days of antibiotic use (OR = 0.13) were independent risk factors for CAUTI (P < 0.05). A total of 31 pathogen strains were detected in urine samples from 18 CAUTI patients. The main pathogens were Gram-positive bacteria (n = 13, 41.9%), fungi (n = 10, 32.3%) and Gram-negative bacteria (n = 7, 22.6%). CAUTI was associated with an increase in hospitalization days by 26 days and an increase in total hospitalization cost of ¥160,000 (P < 0.001). CAUTIs pose an economic and health burden for ICU patients. Repeat catheterization and longer use of antibiotics are to be avoided as much as possible.
How strong is the evidence?
Evidence Hub reads this as a case-control, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause. Reported size: 18 participants or records.
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