Nosocomial Urinary Tract Infections in Urologic Patients: Assessment of a Prospective Surveillance Program Including 10,000 Patients

• Published in: European urology Vol. 41; no. 5; pp. 483 - 489
• Main Authors: Merle, Veronique, Germain, Jeanne-Marie, Bugel, Hubert, Nouvellon, Michèle, Lemeland, Jean-François, Czernichow, Pierre, Grise, Philippe
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier B.V 01.05.2002; Elsevier
• Subjects: Adult; Aged; Biological and medical sciences; Cross Infection - epidemiology; Cross Infection - etiology; Cross-infection; Female; France - epidemiology; Hospitals, University; Humans; Incidence; Indwelling catheter; Male; Medical sciences; Middle Aged; Nephrology. Urinary tract diseases; Prospective Studies; Quality Indicators, Health Care - statistics & numerical data; Risk Factors; Sentinel Surveillance; Surveillance; Urinary Catheterization - adverse effects; Urinary system involvement in other diseases. Miscellaneous; Urinary tract infection; Urinary Tract Infections - epidemiology; Urinary Tract Infections - etiology; Urinary tract. Prostate gland; Urologic Diseases - complications; Urology; France; HUTI, hospital-acquired urinary tract infection; Cross-infection; Urinary tract infection; Surveillance; CDC, Centers for Disease Control; Indwelling catheter; CI95, 95% confidence interval; Urology; Human; Nosocomial infection; Quality; Catheter; Urinary tract; Care; Incidence
• ISSN: 0302-2838; 1873-7560
• DOI: 10.1016/S0302-2838(02)00069-6

Objective: Hospital-acquired urinary tract infections (HUTI) represent a significant impairment in the quality of health care. Incidence in catheterized patients has been estimated at approximately 20%, however few data are available in urologic patients. We report a prospective surveillance program over 6 years in our urologic department and evaluate its evolution. Methods: Population consists of all patients admitted to the urology ward for 48 hours or more over a 6-year period from 1994. Data recorded: age, gender, duration of stay, insertion and removal of catheters, diagnosis of HUTI. Analysis: calculation of incidence, and incidence density for HUTI and for catheter-related HUTI, analysis of trends by χ 2 trend test. Results: A total of 10,054 consecutive patients were included, 52% were catheterized. The median incidence of catheter-related HUTI in catheterized patients was 13.0%, the incidence density was 25.1 HUTI/1000 patient-days of catheterization. The proportion of HUTI and specific catheter-related HUTI patients decreased, respectively from 8.4% and 14.2% to 6.5% and 12.3% during the study period ( p<0.05). Conclusion: The rate of HUTI was not as high as previously reported, perhaps due to a controlled catheter policy. Surveillance was associated with a significant decrease in infection rates, suggesting a beneficial feedback effect. Evaluation of diagnoses and surgical procedures would ensure an optimal quality control program.