Trends in catheter-associated urinary tract infections among a national cohort of hospitalized adults, 2001-2010

• Published in: American journal of infection control 2014, Vol.42 (1), p.17-22
• Main Authors: Daniels, Kelly R., PharmD, Lee, Grace C., PharmD, Frei, Christopher R., PharmD, MSc
• Format: Article
• Language: English
• Subjects: Adult; Adults; Aged; Aged, 80 and over; Bacterial diseases; Bacterial diseases of the urinary system; Biological and medical sciences; Catheter-Related Infections - epidemiology; Catheter-Related Infections - mortality; Catheters; Cross Infection - epidemiology; Cross Infection - mortality; Epidemiology. Vaccinations; Female; General aspects; Health care epidemiology; Health care-associated infections; Hospitalization; Human bacterial diseases; Human infectious diseases. Experimental studies and models; Humans; Incidence; Infection Control; Infectious Disease; Infectious diseases; Length of Stay; Male; Medical device infections; Medical sciences; Middle Aged; Mortality; Population health; Public health; Retrospective Studies; Survival Analysis; United States - epidemiology; Urinary tract diseases; Urinary Tract Infections - epidemiology; Urinary Tract Infections - mortality
• ISSN: 0196-6553; 1527-3296
• DOI: 10.1016/j.ajic.2013.06.026

Background Catheter-associated urinary tract infections (CAUTIs) have become a major public health concern in the United States. This study provides national estimates of CAUTI incidence, mortality, and associated hospital length of stay (LOS) over a 10-year period. Methods This was a retrospective analysis of the National Hospital Discharge Surveys from 2001 to 2010. Adults age ≥18 years with an International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) procedure code for urinary catheter placement or other major procedure were included. Urinary tract infections were identified by ICD-9-CM code. Data weights were applied to derive national estimates. Predictors of CAUTI were identified using a logistic regression model. Results These data represent 70.4 million catheterized patients, 3.8 million of whom developed a CAUTI. The incidence of CAUTIs decreased from 9.4 cases/100 catheterizations in 2001 to 5.3 cases/100 catheterizations in 2010. Mortality in patients with a CAUTI declined from 5.4% in 2001 to 3.7% in 2010. Median (interquartile range [IQR]) hospital LOS also declined, from 9 days (IQR, 5-16 days) in 2001 to 7 days (IQR, 4-12 days) in 2010. Independent predictors of CAUTI included female sex, emergency hospital admission, transfer from another facility, and Medicaid payment ( P < .0001 for all variables). Conclusions The incidence of CAUTIs in US hospitals declined over the study period. Furthermore, patients with these infections experienced lower hospital mortality and shorter hospital LOS.