Risk factors for catheter-associated urinary tract infection in Italian elderly

• Published in: American journal of infection control Vol. 42; no. 8; pp. 898 - 901
• Main Authors: Vincitorio, Daniela, MD, Barbadoro, Pamela, MD, Pennacchietti, Lucia, MD, Pellegrini, Ilaria, MD, PhD, David, Serenella, MD, Ponzio, Elisa, PhD, Prospero, Emilia, MD, MPH
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.08.2014; Elsevier; Mosby-Year Book, Inc
• Subjects: Acute geriatric care; Aged; Aged, 80 and over; Bacterial diseases; Bacterial diseases of the urinary system; Biological and medical sciences; Catheter-Related Infections - epidemiology; Catheters; Epidemiology; Epidemiology. Vaccinations; Female; General aspects; Geriatrics; Health care-associated infection; Health Services for the Aged; Hospitals; Human bacterial diseases; Human infectious diseases. Experimental studies and models; Humans; Incidence; Incidence rate; Infection Control; Infectious Disease; Infectious diseases; Italy - epidemiology; Male; Medical sciences; Morbidity; Mortality; Older people; Risk Factors; Survival Analysis; Urinary tract diseases; Urinary Tract Infections - epidemiology; Italy; Health care-associated infection; Incidence rate; Acute geriatric care; Mortality; Morbidity; Human; Nosocomial infection; Urinary system disease; Prognosis; Acute; Catheter; Check; Urinary tract disease; Epidemiology; Incidence; Prevention; Urinary tract infection; Risk factor; Elderly; Geriatrics
• ISSN: 0196-6553; 1527-3296
• DOI: 10.1016/j.ajic.2014.05.006

Background Catheter-associated urinary tract infections (CAUTIs) are the most common cause of hospital-acquired infections, especially in elderly patients. Data on CAUTIs in older persons in acute care settings are lacking, however. This study aimed to describe the epidemiology of CAUTIs and related outcomes (ie, length of stay and mortality), in patients admitted to an acute geriatric care hospital in central Italy. Methods A CAUTI surveillance program was implemented from October 2011 to April 2012, according to the Centers for Disease Control and Prevention's National Healthcare Safety Network methodology. Results A total of 2773 patients aged ≥65 years were included in the study, and 483 catheterized patients were monitored for the risk of CAUTI. The catheterization rate was 16.7% (95% confidence interval [CI], 15.3%-18.2%), and the overall CAUTI incidence rate was 14.7/1000 device-days (95% CI, 11.7-18.3/1000). Mortality was significantly higher in catheterized patients with a CAUTI compared with noncatheterized patients (19.2% vs 10.5%; P  < .05). Female sex (odds ratio [OR], 1.31; 95% CI, 1.06-1.67), increasing age (≥90 years: OR, 2.76; 95% CI, 2.00-3.83), and longer hospital stay before catheter insertion (≥15 days: OR, 2.90; 95% CI, 2.20-3.83) were independent risk factors for catheterization; increasing age (>90 years: OR, 2.75; 95% CI, 1.03-7.35), and duration of hospital stay before catheter insertion (OR, 2.41; 95% CI, 1.12-5.51) were associated with CAUTIs. Conclusions These results underscore the importance of the proper choice of patients for catheterization, particularly in individuals aged >90 years.