TY - JOUR
T1 - Incidence and risk factors for catheter-associated urinary tract infection in 623 intensive care units throughout 37 Asian, African, Eastern European, Latin American, and Middle Eastern nations
T2 - A multinational prospective research of INICC
AU - Rosenthal, Victor Daniel
AU - Yin, Ruijie
AU - Brown, Eric Christopher
AU - Lee, Brandon Hochahn
AU - Rodrigues, Camilla
AU - Myatra, Sheila Nainan
AU - Kharbanda, Mohit
AU - Rajhans, Prasad
AU - Mehta, Yatin
AU - Todi, Subhash Kumar
AU - Basu, Sushmita
AU - Sahu, Suneeta
AU - Mishra, Shakti Bedanta
AU - Chawla, Rajesh
AU - Nair, Pravin K.
AU - Arjun, Rajalakshmi
AU - Singla, Deepak
AU - Sandhu, Kavita
AU - Palaniswamy, Vijayanand
AU - Bhakta, Arpita
AU - Nor, Mohd Basri Mat
AU - Chian-Wern, Tai
AU - Bat-Erdene, Ider
AU - Acharya, Subhash P.
AU - Ikram, Aamer
AU - Tumu, Nellie
AU - Tao, Lili
AU - Alvarez, Gustavo Andres
AU - Valderrama-Beltran, Sandra Liliana
AU - Jiménez-Alvarez, Luisa Fernanda
AU - Henao-Rodas, Claudia Milena
AU - Gomez, Katherine
AU - Aguilar-Moreno, Lina Alejandra
AU - Cano-Medina, Yuliana Andrea
AU - Zuniga-Chavarria, Maria Adelia
AU - Aguirre-Avalos, Guadalupe
AU - Sassoe-Gonzalez, Alejandro
AU - Aleman-Bocanegra, Mary Cruz
AU - Hernandez-Chena, Blanca Estela
AU - Villegas-Mota, Maria Isabel
AU - Aguilar-De-Moros, Daisy
AU - Castañeda-Sabogal, Alex
AU - Medeiros, Eduardo Alexandrino
AU - Dueñas, Lourdes
AU - Carreazo, Nilton Yhuri
AU - Salgado, Estuardo
AU - Abdulaziz-Alkhawaja, Safaa
AU - Agha, Hala Mounir
AU - El-Kholy, Amani Ali
AU - Daboor, Mohammad Abdellatif
AU - Guclu, Ertugrul
AU - Dursun, Oguz
AU - Koksal, Iftihar
AU - Havan, Merve
AU - Ozturk-Deniz, Suna Secil
AU - Yildizdas, Dincer
AU - Okulu, Emel
AU - Omar, Abeer Aly
AU - Memish, Ziad A.
AU - Janc, Jarosław
AU - Hlinkova, Sona
AU - Duszynska, Wieslawa
AU - Horhat-Florin, George
AU - Raka, Lul
AU - Petrov, Michael M.
AU - Jin, Zhilin
N1 - Publisher Copyright:
© The Author(s), 2024. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America.
PY - 2024/5/4
Y1 - 2024/5/4
N2 - Objective: To identify urinary catheter (UC)-associated urinary tract infection (CAUTI) incidence and risk factors. Design: A prospective cohort study. Setting: The study was conducted across 623 ICUs of 224 hospitals in 114 cities in 37 African, Asian, Eastern European, Latin American, and Middle Eastern countries. Participants: The study included 169,036 patients, hospitalized for 1,166,593 patient days. Methods: Data collection took place from January 1, 2014, to February 12, 2022. We identified CAUTI rates per 1,000 UC days and UC device utilization (DU) ratios stratified by country, by ICU type, by facility ownership type, by World Bank country classification by income level, and by UC type. To estimate CAUTI risk factors, we analyzed 11 variables using multiple logistic regression. Results: Participant patients acquired 2,010 CAUTIs. The pooled CAUTI rate was 2.83 per 1,000 UC days. The highest CAUTI rate was associated with the use of suprapubic catheters (3.93 CAUTIs per 1,000 UC days); with patients hospitalized in Eastern Europe (14.03) and in Asia (6.28); with patients hospitalized in trauma (7.97), neurologic (6.28), and neurosurgical ICUs (4.95); with patients hospitalized in lower-middle-income countries (3.05); and with patients in public hospitals (5.89). The following variables were independently associated with CAUTI: Age (adjusted odds ratio [aOR], 1.01; P <.0001), female sex (aOR, 1.39; P <.0001), length of stay (LOS) before CAUTI-acquisition (aOR, 1.05; P <.0001), UC DU ratio (aOR, 1.09; P <.0001), public facilities (aOR, 2.24; P <.0001), and neurologic ICUs (aOR, 11.49; P <.0001). Conclusions: CAUTI rates are higher in patients with suprapubic catheters, in middle-income countries, in public hospitals, in trauma and neurologic ICUs, and in Eastern European and Asian facilities. Based on findings regarding risk factors for CAUTI, focus on reducing LOS and UC utilization is warranted, as well as implementing evidence-based CAUTI-prevention recommendations.
AB - Objective: To identify urinary catheter (UC)-associated urinary tract infection (CAUTI) incidence and risk factors. Design: A prospective cohort study. Setting: The study was conducted across 623 ICUs of 224 hospitals in 114 cities in 37 African, Asian, Eastern European, Latin American, and Middle Eastern countries. Participants: The study included 169,036 patients, hospitalized for 1,166,593 patient days. Methods: Data collection took place from January 1, 2014, to February 12, 2022. We identified CAUTI rates per 1,000 UC days and UC device utilization (DU) ratios stratified by country, by ICU type, by facility ownership type, by World Bank country classification by income level, and by UC type. To estimate CAUTI risk factors, we analyzed 11 variables using multiple logistic regression. Results: Participant patients acquired 2,010 CAUTIs. The pooled CAUTI rate was 2.83 per 1,000 UC days. The highest CAUTI rate was associated with the use of suprapubic catheters (3.93 CAUTIs per 1,000 UC days); with patients hospitalized in Eastern Europe (14.03) and in Asia (6.28); with patients hospitalized in trauma (7.97), neurologic (6.28), and neurosurgical ICUs (4.95); with patients hospitalized in lower-middle-income countries (3.05); and with patients in public hospitals (5.89). The following variables were independently associated with CAUTI: Age (adjusted odds ratio [aOR], 1.01; P <.0001), female sex (aOR, 1.39; P <.0001), length of stay (LOS) before CAUTI-acquisition (aOR, 1.05; P <.0001), UC DU ratio (aOR, 1.09; P <.0001), public facilities (aOR, 2.24; P <.0001), and neurologic ICUs (aOR, 11.49; P <.0001). Conclusions: CAUTI rates are higher in patients with suprapubic catheters, in middle-income countries, in public hospitals, in trauma and neurologic ICUs, and in Eastern European and Asian facilities. Based on findings regarding risk factors for CAUTI, focus on reducing LOS and UC utilization is warranted, as well as implementing evidence-based CAUTI-prevention recommendations.
KW - Intensive Care Units
KW - Prospective Studies
KW - Urinary Tract Infections/epidemiology
KW - Humans
KW - Catheter-Related Infections/epidemiology
KW - Hospitals, Public
KW - Cross Infection/prevention & control
KW - Catheters
KW - Incidence
UR - https://www.scopus.com/pages/publications/85182654243
UR - https://www.mendeley.com/catalogue/31b6d7bc-28d1-38f4-883b-fa782caa6d99/
U2 - 10.1017/ice.2023.215
DO - 10.1017/ice.2023.215
M3 - Article
C2 - 38173347
AN - SCOPUS:85182654243
SN - 0899-823X
VL - 45
SP - 567
EP - 575
JO - Infection Control and Hospital Epidemiology
JF - Infection Control and Hospital Epidemiology
IS - 5
ER -
SDG 3 Good Health and Well-being