ปัจจัยที่มีผลต่อการติดเชื้อระบบทางเดินปัสสาวะที่สัมพันธ์กับการใส่คาสายสวนปัสสาวะในโรงพยาบาลตติยภูมิ

Yaowalak Anothayanonth

Authors

Yaowalak Anothayanonth Police General Hospital, Pathum Wan, Pathum Wan, Bangkok, 10330, Thailand

Keywords:

catheter-associated urinary tract infection, indwelling catheterization, factors affecting urinary infection

Abstract

A retrospective analytic study was conducted to determine factors associated with catheter-associated urinary tract infection (CAUTI) in inpatient departments, Police General Hospital. Two hundred medical records of patient with urinary catheter insertion between January and December 2019 were reviewed retrospectively. Content validity index (CVI) of data collection form developed by the researcher was .94. Statistical analysis included percentage, mean, and standard deviation. Chi-square test was used to analyze factors associated with CAUTI urinary tract infection. Binary logistic regression analysis was used to predict the probability OR chance of CAUTI.

Result: The rate of CAUTI was 23.32 per 1,000 catheter-days. A logistic regression analysis showed that kidney diseases (OR = 2.95, 95% CI = 1.49 - 5.85, p = .00), diabetes mellitus (OR = 2.46, 95% CI = 1.28 - 4.71, p = .01) and increase one week catheter-days had 1.30 times OR 29.8 percentage (OR = 1.30, 95% CI = 1.15 - 1.47, p = .00) were important factors associated with CAUTI. The equations for prediction with 70.50 % correction.

Suggestion: Apart from strictly adherence to CAUTI prevention guideline, health personnel should manage comorbidities especially kidney diseases and diabetes mellitus appropriately, also re-evaluate of the necessity for urethral catheter insertion to reduce the number of catheter-days.

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References

Allison, S. L., Hojjat, S., David, K. V., Brett, E. Y., Robert, A. G., Yoko, F., David, P. C., & Rimma, P. (2019). Identifying the risk factors for catheter-associated urinary tract infections: A large cross-sectional study of six hospitals. British Medical Journal, 9(2), 1-13.

Armbruster, C. E., Prenovost, K., Mobley, H. L., & Mody, L. (2017). How often do clinically diagnosed catheter-associated urinary tract infections in nursing homes meet standardized criteria?. Journal of the American Geriatrics Society, 65(2), 395-401.

Conover, M. S., Flores-Mireles, A. L., Hibbing, M. E., Dodson, K., & Hultgren, S. J. (2015). Establishment and characterization of UTI and CAUTI in a mouse model. Journal of Visualized Experiments, 100, e52892.

Fei, L., Meixuan, S., Linxia, X., Bo, D., Shiqin, Z., & Xianrong, L. (2019). Risk factors for catheter-associated urinary tract infections among hospitalized patients: A systematic review and meta-analysis of observational studies. Journal of Advanced Nursing, 75(3), 517-527.

Girard, R., Gaujard, S., Pergay, V., Pornon, P., Martin-Gaujard, G., Bourguignon, L., & UTIC Group. (2017). Risk factors for urinary tract infections in geriatric hospitals. Journal of Hospital Infection, 97(1), 74-78.

Henry, M. (2018). Evaluation of evidence-based practice of catheter associated urinary tract infections prevention in a critical care setting: An integrative review. Journal of Nursing Education and Practice, 8(7), 22-30.

Isariyapong, K., & Romanee, C. (2018). Epidemiology of catheter-associated urinary tract infections at Maharaj Nakorn Chiang Mai hospital, Northern Thailand. Southeast Asian Journal of Tropical Medicine and Public Health, 49(1), 113-122.

Kelly, R., Daniels, P., Grace, C. L., & Christropher, R. F. (2014). Trends in catheter-associated urinary tract infections among a national cohort of hospitalized adults 2001-2010. American Journal of Infection control, 42, 17-22.

Khan, Y., Venkateshwarhu, C., Sreenivas, G., & Rahul, P. (2016). Study of incidence and risk factors of urinary tract infection in catheterized patients admitted at tertiary care hospital, Nizamabad, Telangana state, India. International Archives of Integrated Medicine, 3(8), 83-92.

Leelakrishna, P., & Karthik Rao, B. (2018). A study of risk factors for catheter associated urinary tract infection. International Journal of Advances in Medicine, 5(2), 334-339.

Leelakrishna, P., & Karthik, R. B. (2018). A study of risk factors for catheter associated urinary tract Infection. International Journal of Advances in Medicine, 5(2), 334-339.

Leithauser, D. (2005). Urinary tract infections. In R. Carrico, L. Adam, K. Aurden, & L. Fauerbach (Eds.), APIC text of infection control and epidemiology (2nd ed.). Association for Professional in Infection Control and Epidemiology. Washington, DC, USA.

Lo, E., Nicolle, L. E., Coffin, S. E., Gould, C., Maragakis, L. L., Medding, J., . . . Yokoe, D. S. (2014). Strategies to prevent catheter-associated urinary tract infections in acute care hospitals. Infection Control and Hospital Epidemiology, 35(5), 1-17.

Malathum, K. (2015). Infection control guidebook. Retrieved from https://med.mahidol.ac.th/ic/sites/default/files/public/pdf/IC%20book.pdf

Mangukiya, J. D., Patel, K., & Vegad, M. (2015). Study of incidence and risk factors of urinary tract infection in catheterised patients admitted at tertiary care hospital. International Journal of Research in Medical Sciences, 3(12), 3808-11.

Maria, J. L., & Paulo, S. (2017). Hospital-acquired urinary tract infections: Results of a cohort study performed in an internal medicine department. ACTA Medica Portuguesa, 30(9), 608-614.

National Healthcare Safety Network (NSHN). (2020). Urinary tract infection (catheter-associated urinary tract infection [CAUTI] and non-catheter-associated urinary tract infection [UTI]) Events. In Patient Safety Component Manual (pp. 106-125). Retrieved From https://www.cdc.gov/nhsn/pdfs/pscmanual/pcsmanual_current.pdf

Thungklin, B., Khiewkhern, O., & Phitakaramwong, P. (2017). Factor that affecting catheter-associated urinary tract infection among retained urinary catheter patient, inpatients department, Pichit hospital. Pichit Hospital Journal, 32(2), 31-41.

Unahalekhaka, A. (2013). Epidemiology an evidence-based practice guideline in prevention of hospital-associated infections. Chiang Mai: Mingmuang.

Vincitorio, D., Barbadoro, P., Pennacchietti, L., Pellegrini, L., David, S., & Ponzio, E. (2014). Risk factors for catheter-associated urinary tract infection in Italian elderly. American Journal of Infection Control, 45(8), 898-901.

Zhao, X., Wang, L., Wei, N., Zhang, J., Ma, W., Zhao, H., & Han, X. (2019). Risk factors of health care-associated infection in elderly patients: A retrospective cohort study performed at a tertiary hospital in China. BMC Geriatrics, 19, 1-6.