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Catheter-Associated Urinary Tract Infections in Intensive Care Unit Patients

Published online by Cambridge University Press:  20 July 2015

Rudy Tedja ,
Jean Wentink ,
John C O’Horo ,
Rodney Thompson  and
Priya Sampathkumar
Rudy Tedja*
Affiliation:
Division of Critical Care Medicine, Mayo Clinic, Rochester, Minnesota
Jean Wentink
Affiliation:
Infection Prevention and Control, Mayo Clinic, Rochester, Minnesota
John C O’Horo
Affiliation:
Division of Infectious Disease, Mayo Clinic, Rochester, Minnesota
Rodney Thompson
Affiliation:
Division of Infectious Disease, Mayo Clinic, Rochester, Minnesota Infection Prevention and Control, Mayo Clinic, Rochester, Minnesota
Priya Sampathkumar
Affiliation:
Division of Infectious Disease, Mayo Clinic, Rochester, Minnesota Infection Prevention and Control, Mayo Clinic, Rochester, Minnesota
*
Address correspondence to Rudy Tedja, 200 First Street SW, Marian Hall 2-115, Rochester, MN 55905 (tedja.rudy@mayo.edu).
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Abstract

OBJECTIVE

To delineate the epidemiology of catheter-associated urinary tract infections (CAUTIs) and to better understand the value of urine cultures for evaluation of fever in the intensive care unit (ICU) setting

DESIGN

Two-year retrospective review (2012–2013)

SETTING

A single tertiary center with 1,200 hospital beds and 158 adult ICU beds

PATIENTS

ICU patients with a CAUTI event

METHODS

The cohort was identified from a prospective infection prevention database. Charts were reviewed to characterize the patients. CAUTI rates and device utilization ratio (DUR) were calculated. Clinical outcomes were recorded.

RESULTS

A total of 105 CAUTIs were identified using the National Health and Safety Network (NHSN) definition. Fever was the primary indication for obtaining urine culture in 102 patients (97%). Of these 105 patients, 51 (51%) had an alternative infection to explain the fever, with pneumonia (55%) being the most common followed by bloodstream infection (22%). A total of 18 patients (18%) had fever due to noninfectious cause, and 32 patients (32%) had no alternative explanation. Of these, 66% received appropriate empiric antimicrobial therapy, but no targeted therapy changes were made based on urine culture results. The other 34% did not receive antimicrobial therapy at all. Only 6% of all CAUTIs resulted in blood cultures positive for the same organism within 2 days. The urinary tract was not definitely established as the source of bloodstream infection.

CONCLUSIONS

Urine cultures obtained for evaluation of fever form the basis for identification of CAUTIs in the ICU. However, most patients with CAUTIs are eventually found to have alternative explanations for fever. CAUTI is associated with a low complication rate.

Infect. Control Hosp. Epidemiol. 2015;36(11):1330–1334

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 36 , Issue 11 , November 2015 , pp. 1330 - 1334
Copyright
© 2015 by The Society for Healthcare Epidemiology of America. All rights reserved 

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