Factors predicting catheter-associated urinary tract infections in critically ill internal medicine patients
Keywords:
indwelling urinary catheter, predictive factors, critically ill patientAbstract
This prospective cohort study was conducted to identify predictive factors for catheter-associated urinary tract infections (CAUTI) in critically ill internal medicine patients in an intensive care unit (ICU). Subjects were 263 critically ill internal medicine patients with indwelling urinary catheter admitted in the medical intensive care unit (MICU) during January and April 2024. Data were collected from medical records using a demographic information form, CAUTI risk factors assessment form, and CAUTI diagnostic form. Descriptive statistics were used to summarize demographic information and CAUTI risk factors characteristics. Logistic regression analysis was used to identify factors predictive of CAUTI.
Results revealed that predictive factors for CAUTI in critically ill internal medicine patients were: having history of urinary tract infection (UTI) in the past six months (OR=11.74 [95% CI: 1.40, 98.72], p=.023), diabetes mellitus (OR=4.74 [95% CI: 1.86, 12.11], p=.001), repeated catheterization (OR=25.73 [95% CI: 1.69, 390.86], p=.019), and ICU length of stay (OR=1.60 [95% CI: 1.32, 1.94], p<.001). Therefore, healthcare professionals should increase the awareness and closely monitor CAUTI in critically ill internal medicine patients with a history of UTI in the past six months, diabetes mellitus, repeated catheterization and prolonged ICU stay.
References
Magill SS, O'Leary E, Janelle SJ, Thompson DL, Dumyati G, Nadle J, et al. Changes in prevalence of health care-associated infections in U.S. Hospitals. NEJM 2018;379(18):1732-44.
Centers for Disease Control and Prevention (CDC). Guideline for prevention of catheter-associated urinary tract infection (2009): update 2019 [Internet]. 2024 [update 2024; cite 2024 Arp 20]; Available from: https://www.cdc.gov/infectioncontrol/guidelines/ cauti/index.html
Gould CV, Umscheid CA, Agarwal RK, Kuntz G, Pegues DA. Healthcare Infection Control Practices Advisory Committee (HICPAC): guideline for prevention of catheter-associated urinary tract infections 2009 [Internet]. 2024 [update 2024; cite 2024 Arp 22]; Available from: https://www.cdc.gov/infectioncontrol/ pdf/guidelines/cauti-guidelines-H.pdf
National Healthcare Safety Network (NHSN). Urinary tract infection (Catheter-associated urinary tract infection (CAUTI) and non-catheter-associated urinary tract infection (UTI)) events [Internet]. 2024 [update 2024; cite 2024 Arp 22]; Available from: https://www.cdc.gov/nhsn/pdfs/pscmanual/7psccauticurrent.pdf
Hollenbeak CS, Schilling AL. The attributable cost of catheter-associated urinary tract infections in the United States: a systematic review. American Journal of Infection Control 2018;46(7):751-7.
Rousseau M, Goh HMS, Holec S, Albert ML, Williams RB, Ingersoll MA, et al. Bladder catheterization increases susceptibility to infection that can be prevented by prophylactic antibiotic treatment. JCI Insight 2016;1(15):e88178.
Li F, Song M, Xu L, Deng B, Zhu S, Li X. Risk factors for catheter-associated urinary tract infection among hospitalized patients: a systematic review and meta-analysis of observational studies. Journal of Advanced Nursing 2019;75(3):517-27.
Kotikula I, Chaiwarith R. Epidemiology of catheter associated urinary tract infections at Maharaj Nakorn Chiang Mai Hospital, Northern Thailand. The Southeast Asian Journal of Tropical Medicine and Public Health 2018;49(1):113-22. (in Thai)
Wongsri P, Thongmaha S. Butsing N, Skuntaniyom S, Wongprikorn A. Risk factors of catheter-associated urinary tract infection in a tertiary-care medical center. Nurs Res Inno J 2023;29(3):303-18. (in Thai)
Farsi AH. Risk factors and outcomes of postoperative catheter-associated urinary tract infection in colorectal surgery patients: a retrospective cohort study. Cureus 2021;13(5):e15111.
Letica-Kriegel AS, Salmasian H, Vawdrey DK, Youngerman BE, Green RA, Furuya EY, et al. Identifying the risk factors for catheter-associated urinary tract infections: a large cross-sectional study of six hospitals. BMJ Open 2019;9(2):e022137.
Anggi A, Wijaya DW, Ramayani OR. Risk factors for catheter-associated urinary tract infection and uropathogen bacterial profile in the intensive care unit in hospitals in Medan, Indonesia. Open Access Macedonian Journal of Medical Sciences 2019;7(20):3488-92.
Perrin K, Vats A, Qureshi A, Hester J, Larson A, Felipe A, et al. Catheter-associated urinary tract infection (CAUTI) in the neuro ICU: identification of risk factors and time-to-CAUTI using a case control design. Neurocrit Care 2021;34(1):271-8.
Assawapalanggool S, Nuankum T. Risk factors and consequences of drug-resistant urinary tract infections in Thai-Myanmar border hospitals in the northern region [Internet]. 2023 [update 2024; cite 2024 Arp 22]; Available from: https://hpc2appcenter. anamai.moph.go.th/academic/web/files/2566/preproceeding/abstract/research/61_abstract.docx
Toimamueang U, Chotikawanich E, Thepsuthammarat K. Incidence and risk factors of catheter-associated urinary tract infections in in kidney transplant recipients. Journal of Nursing and Health Care 2015;33(1);115-26. (in Thai)
Omer SA, Zahran FE, Ibrahim A, Sidahmed LA, Karam G, Almuhim F, et al. Risk factors for catheter associated urinary tract infections (CAUTI) in medical wards and intensive care units (ICU). Journal of Microbiology Research 2020;10(1):1-5.
Thungklin B, Khiewkhern O, Phitakaramwong P. Factor that affecting catheter-associated urinary tract infection among retained urinary catheter patient, inpatients department, Pichit Hospital. Phichit Hospital Journal 2017;32(2):31-41. (in Thai)
Anothayanonth Y. Factors that affecting catheter-associated urinary tract infection in tertiary hospital. JPNHS 2020;12(1):48-57. (in Thai)
Barchitta M, Maugeri A, Favara G, RielaPM, La Mastra C, La Rosa MC, et al. Cluster analysis identifies patients at risk of catheter-associated urinary tract infections in intensive care units: findings from the SPIN-UTI Network. Journal of Hospital Infection 2021;107:57-63. 20.
Ndomba ALM, Laisser RM, Silago V, Kidenya BR, Mwanga J, Seni J, et al. Urinary tract infections and associated factors among patients with indwelling urinary catheters attending Bugando medical Center a tertiary hospital in Northwestern Tanzania. Microorganisms 2022;10(2):473.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Journal of Nursing Science and Health
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
The Journal of Nursing Science and Health is copyright holder of published articles. Distributions of articles published in Journal of Nursing Science and Health including online, photocopying which is not for teaching-learning purpose, publication submission elsewhere are prohibited except obtaining permission from the Journal of Nursing Science and Health.
