Hostname: page-component-586b7cd67f-2brh9 Total loading time: 0 Render date: 2024-12-01T01:46:53.159Z Has data issue: false hasContentIssue false
  • English
  • Français

A Multivariate Analysis of Risk Factors for Acquiring Bacteriuria in Patients With Indwelling Urinary Catheters for Longer Than 24 Hours

Published online by Cambridge University Press:  02 January 2015

Mervyn Shapiro ,
Elisheva Simchen ,
Shai Izraeli  and
Theodore G. Sacks
Mervyn Shapiro*
Affiliation:
Departments of Clinical Microbiology and Social Medicine, Hadassah University Hospital, andHebrew University—Hadassah Medical School, Jerusalem, Israel
Elisheva Simchen
Affiliation:
Departments of Clinical Microbiology and Social Medicine, Hadassah University Hospital, andHebrew University—Hadassah Medical School, Jerusalem, Israel
Shai Izraeli
Affiliation:
Departments of Clinical Microbiology and Social Medicine, Hadassah University Hospital, andHebrew University—Hadassah Medical School, Jerusalem, Israel
Theodore G. Sacks
Affiliation:
Departments of Clinical Microbiology and Social Medicine, Hadassah University Hospital, andHebrew University—Hadassah Medical School, Jerusalem, Israel
*
Department of Clinical Microbiology, Hadassah University Hospital, P.O.B. 12 000, Jerusalem, Israel
Get access Rights & Permissions [Opens in a new window]

Abstract

Data related to risk factors for catheter-acquired bacteriuria were collected prospectively on 112 patients consecutively catheterized for >24 hours at the Hadassah University Hospital. Logistic regression analysis indicated that factors independently associated (p≤0.05) with a higher risk of catheter-acquired bacteriuria were as follows: hospitalization in orthopedics or urology, ethnic origin (Arabs > Jews), insertion of a catheter after the sixth day of hospitalization, catheterization outside the operating theaters, lack of administration of systemic antibiotics, unsatisfactory catheter care, and prolonged duration (≥7 days) of catheterization before infection occurred. The risk associated with catheterization outside the operating theater could be explained by its correlate, that is, catheterization for incontinence/obstruction as opposed to output measurement. Life-table analyses demonstrated that the daily risk for acquiring bacteriuria during the first six days of catheterization was higher among patients ultimately catheterized for ≥7 days than among those ultimately catheterized for < 7 days (P<0.05).

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 5 , Issue 11 , November 1984 , pp. 525 - 532
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1984

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Clark, A: Remarks on catheter fever. Lancet 1883;2:1075–1077.Google Scholar
2.Dukes, C: Urinary infections after excision of the rectum. Their cause and prevention. Proceedings of the Royal Society of Medicine 1928;22:259–269.CrossRefGoogle ScholarPubMed
3.Beeson, PB: The case against the catheter. Am J Med 1958;24:1–3.CrossRefGoogle ScholarPubMed
4.Kunin, CM, McCormack, RC: Prevention of catheter-induced urinary tract infections by sterile closed drainage. N Engl J Med 1966;274:1155–1161.CrossRefGoogle ScholarPubMed
5.Garibaldi, RA, Burke, JP, Dickman, ML, et al: Factors predisposing to bacteriuria during indwelling urethral catheterization. N Engl J Med 1974;291:215–219.CrossRefGoogle ScholarPubMed
6.Warren, JW, Platt, R, Thomas, RJ, et al: Antibiotic irrigation and catheter-associated urinary tract infections. N Engl J Med 1978;299:570–573.CrossRefGoogle ScholarPubMed
7.Turck, M, Stamm, W: Nosocomial infection of the urinary tract. Am J Med 1981;70:651–654.CrossRefGoogle ScholarPubMed
8.DuPont, HL, Spink, WW: Infections due to Gram-negative organisms: An analysis of 860 patients with bacteriuria at the University of Minnesota Medical Center. Medicine 1969;48:307–332.CrossRefGoogle Scholar
9.Kreger, BE, Craven, DE, Carling, PC, et al: Gram-negative bacteremia. III. Re-assessment of etiology, epidemiology and ecology in 612 patients. Am J Med 1980;68:332–343.CrossRefGoogle Scholar
10.Givens, CD, Wenzel, RP: Catheter associated urinary tract infections in surgical patients: A controlled study on the excess morbidity and costs. J Urol 1980;124:646–648.CrossRefGoogle Scholar
11.Platt, R, Polk, BF, Murdock, B, et al: Mortality associated with nosocomial urinary-tract infection. N Engl J Med 1982;307:637–642.CrossRefGoogle ScholarPubMed
12.Platt, R, Polk, BF, Murdoc, B, et al: Reduction of mortality associated with nosocomial urinary tract infection. Lancet 1983;1:893–897.CrossRefGoogle ScholarPubMed
13.Garibaldi, RA, Burke, JP, Britt, MR, et al: Meatal colonization and catheter associated bacteriuria. N Engl J Med 1980;303:316–318.CrossRefGoogle ScholarPubMed
14.Burke, JP, Garibaldi, RA, Britt, MR, et al: Prevention of catheter associated urinary tract infections. Efficacy of daily meatal care regimens. Am J Med 1981;70:655–658.CrossRefGoogle ScholarPubMed
15.Haley, RW, Hooton, TM, Culver, DH, et al: Nosocomial infections in US hospitals 1975-1976. Estimated frequency by selected characteristics of patients. Am J Med 1981;70:947–958.CrossRefGoogle ScholarPubMed
16.Hooton, TM, Haley, RW, Culver, DH, et al: The joint association of multiple risk factors with the occurrence of nosocomial infection. Am J Med 1981;70:960–970.CrossRefGoogle ScholarPubMed
17.Miettinen, OS: Estimability and estimation in case-referent studies. Am J Epidemiol 1976;103:226–235.CrossRefGoogle ScholarPubMed
18.Cox, DR: The Analysis of Binary Data. London, Methuen and Co, 1970, p 14.Google Scholar
19.Peto, R, Pike, MC, Armitage, P, et al: Design and analysis of randomized clinical trials requiring prolonged observation of each patient. II. Analysis and examples. Br J Cancer 1977;35:1–39.CrossRefGoogle ScholarPubMed
20.Simchen, E, Shapiro, M, Michel, J, et al: Multivariate analysis of determinants of postoperative wound infection: A possible basis for intervention. Rev Infect Dis 1981;3:678–682.CrossRefGoogle ScholarPubMed
21.Simchen, E, Shapiro, M, Marin, G, et al: Risk factors for postoperative wound infection in cardiac surgery patients: The relative contribution of host and patient-care factors. Infect Control 1983;4:215–220.CrossRefGoogle Scholar
22.Cruse, PJE, Ford, R: A five-year prospective study of 23,649 surgical wounds. Arch Surg 1973;107:206–209.CrossRefGoogle Scholar
23.National Research Council ad hoc Committee Report on postoperative wound infections: The influence of ultraviolet irradiation in the operating room and of various other factors. Ann Surg 1964; 160(Suppl 2):1–192.Google Scholar
24.Polk, BF, Tager, IB, Shapiro, M, et al: Randomized clinical trial of perioperative cefazolin in preventing infection after hysterectomy. Lancet 1980;1:437–440.CrossRefGoogle ScholarPubMed
25.Kass, EH, Schneiderman, LJ: Entry of bacteria into the urinary tracts of patients with inlying catheters. N Engl J Med 1957;256:556–557.CrossRefGoogle ScholarPubMed