Evan C Bursle1, Jane Dyer2, David F M Looke3, David A J McDougall4, David L Paterson5, E G Playford6. 1. Infection Management Services, Princess Alexandra Hospital, Woolloongabba, Brisbane 4102, Australia; University of Queensland, School of Medicine, Brisbane, Queensland, Australia. Electronic address: evanbursle@gmail.com. 2. Infection Management Services, Princess Alexandra Hospital, Woolloongabba, Brisbane 4102, Australia; University of Queensland, School of Medicine, Brisbane, Queensland, Australia. Electronic address: jane.dyer@health.qld.gov.au. 3. Infection Management Services, Princess Alexandra Hospital, Woolloongabba, Brisbane 4102, Australia; University of Queensland, School of Medicine, Brisbane, Queensland, Australia. Electronic address: david.looke@health.qld.gov.au. 4. Infection Management Services, Princess Alexandra Hospital, Woolloongabba, Brisbane 4102, Australia. Electronic address: david.mcdougall@health.qld.gov.au. 5. University of Queensland Centre for Clinical Research, Royal Brisbane and Women's Hospital, Queensland 4006, Australia. Electronic address: david.paterson@health.qld.gov.au. 6. Infection Management Services, Princess Alexandra Hospital, Woolloongabba, Brisbane 4102, Australia; University of Queensland, School of Medicine, Brisbane, Queensland, Australia. Electronic address: geoffrey.playford@health.qld.gov.au.
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.
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.
Authors: Hosam M Zowawi; Patrick N A Harris; Matthew J Roberts; Paul A Tambyah; Mark A Schembri; M Diletta Pezzani; Deborah A Williamson; David L Paterson Journal: Nat Rev Urol Date: 2015-09-01 Impact factor: 14.432
Authors: M Todd Greene; Sanjay Saint; David Ratz; Latoya Kuhn; Jennifer Davis; Payal K Patel; Mary A M Rogers Journal: Am J Infect Control Date: 2018-11-20 Impact factor: 2.918