Analysis of Risk Factors for Urinary Catheter-Associated Urinary Tract Infection in Patients with Ischaemic Stroke Based on a Single-Centre Nursing Experience.

Abstract

Objective: This study aimed to investigate the risk factors for catheter-associated urinary tract infection (CAUTI) in patients with ischaemic stroke and provide a scientific basis for developing targeted preventive and nursing measures.

Methods: A retrospective cohort study was conducted to study patients with ischaemic stroke and indwelling catheterisation admitted to the Emergency Department of Beijing Tiantan Hospital, Capital Medical University from December 2023 to February 2025. During hospitalisation, quality control was carried out in strict accordance with the consistent nursing operation of the patient's urethral catheter insertion and daily maintenance of the urinary catheter. According to the occurrence of urinary tract infection recorded by the medical record system, the patients were divided into infected group and non-infected group. Univariate and multivariate logistic regression analyses were conducted to examine the general information and relevant risk factors of the two patient groups.

Results: A total of 998 patients with ischaemic stroke were hospitalised and received indwelling urinary catheter care. Among them, 87 patients developed CAUTI, yielding an incidence rate of 8.72%. A total of 376 pathogenic bacteria were identified from the 87 patients with ischaemic stroke who developed CAUTI. The patients were divided into an infected group (n = 87) and a non-infected group (n = 911) according to the occurrence of CAUTI. Logistic regression analysis revealed that age ≥60 years (odds ratio (OR) = 0.525, 95% confidence interval (CI) = 0.314-0.877), body mass index (BMI) ≥28.1 kg/m² (OR = 3.219, 95% CI = 1.446-5.630), diabetes (OR = 2.901, 95% CI = 2.238-3.386), parenteral nutrition support (OR = 2.943, 95% CI = 2.113-3.223), indwelling urinary catheter time ≥6 days (OR = 0.689, 95% CI = 0.193-0.985), number of catheter intubations ≥2 times (OR = 1.733, 95% CI = 0.345-3.513) and time to use antimicrobials ≥7 days (OR = 0.756, 95% CI = 0.418-1.356) were all risk factors for the development of CAUTI in patients with ischaemic stroke (p < 0.05).

Conclusions: Age, BMI, diabetes mellitus, parenteral nutrition support, time of indwelling urinary catheter, number of catheter intubations and time of antimicrobial use are the risk factors for CAUTI in patients with ischaemic stroke. Preventive measures and care strategies considering these risk factors can be taken to reduce the risk of infection.