Risk factors for catheter-associated urinary tract infection in an intensive care unit: a matched case-control study.

Abstract

Objective: Catheter-associated urinary tract infections (CAUTIs) are common healthcare-related infections in intensive care units (ICUs). This study investigated the risk factors for CAUTIs in critically ill patients.

Methods: This study was a single-centre, retrospective, matched case-control study of patients undergoing indwelling catheterization in the ICU from December 1, 2016, to October 31, 2021. Patients with catheterizations were matched 1:4 with controls that were hospitalized in the ICU during the same period (with a difference in admission time of no more than two months).

Results: CAUTI occurred in 18 of 403 patients, with an infection rate of 3.7/per 1000 catheter days. Repeat catheterization of the urinary catheter (OR = 10.09) and days of antibiotic use (OR = 0.13) were independent risk factors for CAUTI (P < 0.05). A total of 31 pathogen strains were detected in urine samples from 18 CAUTI patients. The main pathogens were Gram-positive bacteria (n = 13, 41.9%), fungi (n = 10, 32.3%) and Gram-negative bacteria (n = 7, 22.6%). CAUTI was associated with an increase in hospitalization days by 26 days and an increase in total hospitalization cost of ¥160,000 (P < 0.001).

Conclusion: CAUTIs pose an economic and health burden for ICU patients. Repeat catheterization and longer use of antibiotics are to be avoided as much as possible.