Catheter-Associated Urinary Tract Infections, Bacteremia, and Infection Control Interventions in a Hospital: A Six-Year Time-Series Study

Abstract

Catheter-associated urinary tract infections (CAUTIs) are among the most common healthcare-associated infections. Urine catheters are often reservoirs of multidrug-resistant (MDR) bacteria and sources of pathogens transmission to other patients. The current study was conducted to investigate the correlation between CAUTIs, MDR bacteremia, and infection control interventions, in a tertiary-care hospital in Athens, from 2013 to 2018. The following data were analyzed per month: 1. CAUTI incidence; 2. consumption of hand hygiene disinfectants; 3. incidence of isolation of MDR carrier patients, and 4.incidence of bacteremia/1000 patient-days [total resistant a.Gram-negative: carbapenem-resistant Pseudomonas aeruginosa, Acinetobacter baumannii, and Klebsiella pneumoniae; b.Gram-positive: vancomycin-resistant Enterococci and methicillin-resistant Staphylococcus aureus]. The use of scrub disinfectant solutions was associated with decreased CAUTI rate in Total Hospital Clinics (OR: 0.97, 95% CI: 0.96–0.98, p-value: <0.001) and in Adults ICU (OR: 0.79, 95% CI: 0.65–0.96, p-value:0.018) while no correlation was found with isolation rate of MDR-carrier pathogens. Interestingly, an increase in total bacteremia (OR: 0.81, 95% CI: 0.75–0.87, p-value:<0.001) or carbapenem-resistant bacteremia correlated with decreased incidence of CAUTIs (OR: 0.96, 95% CI: 0.94–0.99, p-value: 0.008). Hand hygiene measures had a robust and constant effect on infection control, reducing the incidence of CAUTIs.

Biomimetic urine flow control can preserve bladder function in patients with indwelling catheterization

“…Urine catheters are often reservoirs of multidrug-resistant bacteria and sources of pathogens transmission to other patients. [ 19 ] The urinary tract is the commonest source of nosocomial infection, particularly when the bladder is catheterized. [ 13 ] Urinary tract infections related to catheters often occur in the medical system.…”

Infección del tracto urinario asociada a catéter urinario

“…En pacientes que pertenecen a unidades de cuidado intensivo, los agentes más comunes son Candida spp y Enterococcus spp. Además, los pacientes pediátricos en este mismo tipo de unidades suelen tener gérmenes como E. coli con alta resistencia a la antibioticoterapia (1,2). El microorganismo más frecuente en pacientes que ya han recibido terapia antibiótica profiláctica es Pseudomona sp.…”

“…La infección del tracto urinario asociada a catéter urinario (ITU-ACU), al ser una infección frecuente asociada al ambiente hospitalario, puede representar múltiples complicaciones a corto y largo plazo para el paciente asociado al alto costo hospitalario que significa (1,2). Desde el 2011 se reconoció que la infección del tracto urinario (ITU) se encontraba dentro de las primeras cuatro infecciones más frecuentes a nivel nosocomial, y en su mayoría se asociaba a catéter urinario (3).…”

Anti-infective Efficacy of Duloxetine against Catheter-Associated Urinary Tract Infections Caused by Gram-Positive Bacteria

“…4 Indwelling catheters are mainly used for urine drainage in hospitalized patients; in certain circumstances, the occurrence of infections through catheter usage plays a serious role in catheter-associated urinary tract infections (CAUTIs), which affect more than a million people globally. 5,6 In accordance, CAUTIs rank as the third most significant contributor to nosocomial infections, accounting for a substantial 40% of total healthcare-related infections. This alarming prevalence is associated with elevated rates of morbidity and mortality.…”

“…Particularly, indwelling catheters play a dynamic role in the medical era by supporting hospitalized patients to overcome illnesses arising due to various reasons. − Medical devices present in the human body provide the appropriate microenvironment for suitable microbial colonization resulting in the emergence of hospital-acquired infections . Indwelling catheters are mainly used for urine drainage in hospitalized patients; in certain circumstances, the occurrence of infections through catheter usage plays a serious role in catheter-associated urinary tract infections (CAUTIs), which affect more than a million people globally. , In accordance, CAUTIs rank as the third most significant contributor to nosocomial infections, accounting for a substantial 40% of total healthcare-related infections. This alarming prevalence is associated with elevated rates of morbidity and mortality. , Long-term catheter usage provides the opportunity for uropathogen colonization in the urinary tract region, leading to various difficulties such as bacteriuria, sepsis, extended stay in the hospital, high treatment cost, chances for antibiotic resistance, and, in some cases, high mortality rates, which cause a severe economic burden. − Most importantly, CAUTI favors polymicrobial structures, including Gram-positive as well as Gram-negative etiological agents.…”