Incidence of catheter-related urinary tract infections in a medical ward

Authors

  • Maria do Céu Dória Serviço de Medicina do Centro Hospitalar de Cascais
  • Filipa Barros Serviço de Medicina do Centro Hospitalar de Cascais
  • Ana Vanessa Vicente Serviço de Medicina do Centro Hospitalar de Cascais
  • José Lomelino Araújo Serviço de Medicina do Centro Hospitalar de Cascais

Keywords:

Indwelling urinary catheter, Bacteriuria, Urinary tract infection

Abstract

Introduction and objectives: The indwelling urinary tract catheter
(IUTC) is an important part of medical care. Up to 25% of patients
admitted in hospitals are catheterized, of which, a high percentage are not justified. Catheter associated urinary tract infection
(CAUTI) is the most common nosocomial infection documented, accounting for more than 40% of the total.
Almost all patients admitted to an Internal Medicine ward in
our hospital, pass through the Emergency Department, where
they stay until there is a bed available. Therefore, a high number
of patients have an IUTC at the time of medical ward admission.
With this study we pretended to analyse the incidence of CAUTI
in patients catheterized after hospital admission.
Material and methods: Over a seven month time period, all the
patients admitted to the medical ward with an IUTC, were included
in the study. The urinary catheter was left in situ in those who
had a clear indication. If no need for catheterisation was found,
a urine sample was collected for culture, and the IUTC removed.
Patients admitted with the diagnosis of urinary tract infection were excluded.
In the study population we studied the motive stated for catheterization, the sex/age distribution, the percentage of positive
urine cultures and the pathogens involved.
Results: During this study, 15% (n=60) of the admitted patients
had an IUTC. The reason stated for catheterization was to measure urinary output in 66.7% of the patients, urinary retention
in 10% and no justification determined in 21.7% of the cases.
In the studied population 93.3% (n=56) had no indication to
maintain the IUTC. The results of the urine culture performed in
these patients were positive in 23.2% (n=13), all with a IUTC in
place for more than 3 days. Of those who had a negative urine
culture result (n=40), 65% had already been medicated with a
broad spectrum antibiotic for more then 48 hours; this fact could
underestimate the number of CAUTI.

Downloads

Download data is not yet available.

References

Stamm WE. Catheter-associated urinary tract infections: epidemiology, pathogenesis and prevention. Am J Med 1991;91(3B):65S-71S

Stain S, Lipsky BA. Preventing catheter-related bacteriuria: should we? Can we? How? Arch Intern Med 1999 ;159(8):800-808.

Tambyah PA, Maki DG. Catheter-associated urinary tract infection is rarely symptomatic: a prospective study of 1497 catheterized patiens. Arch Intern Med 2000;160:678-682.

Maki DG. Nosocomial bacteremia. An epidemiologic overview. Am J Med An epidemiologic overview. Am J Med1981;70:719-732.

Platt R, Polk BF, Murdock B, Rosner B. Mortality associated with nosocomial urinary-tract infection. N Engl J Med 1982;307:637-641. N Engl J Med 1982;307:637-641.

Kunin CM, Douthitt S, Dancing J, Anderson J, Moeschberger M. The association between the use of urinary catheters and morbidity and mortality among elderly patients in nursing homes. Am J Epidemiol 1992;135:291-301.

Jarvis WR, Martone WJ. Predominant pathogens in hospital infections. Antimicrob Chemother 1992;29:19-24.

Jain P, Parada JP, David A, Smith LG. Overuse of the indwelling urinary tract catheter in hospitalized medical patients. Arch Intern Med 1955;155:1425-1429.

Sanjay Saint. Indwelling urinary catheters: a one-point restraint? Ann Intern Med 2002 ;137(2):125:7

Platt R, Polk BF, Murdock B, Rosner B. Risk factors for nosocomial urinary tract infection. Am J Epidemiol 1986;124:977-985.

Maki DG, Tambyah PA. Engineering out the risk of infection with urinary catheters. Emerging Infectious Disease 2001; 7(2):2:5

Additional Files

Published

2007-03-30

How to Cite

1.
Dória M do C, Barros F, Vicente AV, Araújo JL. Incidence of catheter-related urinary tract infections in a medical ward. RPMI [Internet]. 2007 Mar. 30 [cited 2024 Nov. 4];14(1):12-5. Available from: https://revista.spmi.pt/index.php/rpmi/article/view/1527

Issue

Section

Original Articles

Most read articles by the same author(s)