Prospective cohort study of incidence and risk factors for catheter-associated urinary tract infections in 145 intensive care units of 9 Latin American countries: INICC findings.

Humans Female Cross Infection / epidemiology Catheter-Related Infections / complications Prospective Studies Incidence Latin America / epidemiology Urinary Tract Infections / etiology Intensive Care Units Catheters, Indwelling / adverse effects Risk Factors

Catheter-associated urinary tract infections INICC Incidence Intensive care units Rates Risk factors

Journal

World journal of urology

ISSN: 1433-8726

Titre abrégé: World J Urol

Pays: Germany

ID NLM: 8307716

Informations de publication

Date de publication:
Dec 2023

Historique:

received: 04 05 2023

accepted: 16 09 2023

medline: 4 12 2023

pubmed: 12 10 2023

entrez: 12 10 2023

Statut: ppublish

Résumé

Identify urinary catheter (UC)-associated urinary tract infections (CAUTI) incidence and risk factors (RF) in Latin American Countries. From 01/01/2014 to 02/10/2022, we conducted a prospective cohort study in 145 ICUs of 67 hospitals in 35 cities in nine Latin American countries: Argentina, Brazil, Colombia, Costa Rica, Dominican Republic, Ecuador, Mexico, Panama, and Peru. To estimate CAUTI incidence, we used the number of UC-days as the denominator, and the number of CAUTIs as numerator. To estimate CAUTI RFs, we analyzed the following 10 variables using multiple logistic regression: gender, age, length of stay (LOS) before CAUTI acquisition, UC-days before CAUTI acquisition, UC-device utilization (DU) ratio, UC-type, hospitalizationtype, ICU type, facility ownership, and time period. 31,631 patients, hospitalized for 214,669 patient-days, acquired 305 CAUTIs. The pooled CAUTI rate per 1000 UC-days was 2.58, for those using suprapubic catheters, it was 2.99, and for those with indwelling catheters, it was 2.21. The following variables were independently associated with CAUTI: age, rising risk 1% yearly (aOR = 1.01; 95% CI 1.01-1.02; p < 0.0001 female gender (aOR = 1.28; 95% CI 1.01-1.61; p = 0.04), LOS before CAUTI acquisition, rising risk 7% daily (aOR = 1.07; 95% CI 1.06-1.08; p < 0.0001, UC/DU ratio (aOR = 1.14; 95% CI 1.08-1.21; p < 0.0001, public facilities (aOR = 2.89; 95% CI 1.75-4.49; p < 0.0001. The periods 2014-2016 and 2017-2019 had significantly higher risks than the period 2020-2022. Suprapubic catheters showed similar risks as indwelling catheters. The following CAUTI RFs are unlikely to change: age, gender, hospitalization type, and facility ownership. Based on these findings, it is suggested to focus on reducing LOS, UC/DU ratio, and implementing evidence-based CAUTI prevention recommendations.

Identifiants

DOI: 10.1007/s00345-023-04645-z PMID: 37823942

pubmed: 37823942

doi: 10.1007/s00345-023-04645-z

pii: 10.1007/s00345-023-04645-z

doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

Pagination

3599-3609

Informations de copyright

Références

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