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: A multinational prospective research of INICC
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Authors
Rosenthal, Victor DanielYin, Ruijie
Brown, Eric Christopher
Lee, Brandon Hochahn
Rodrigues, Camilla
Myatra, Sheila Nainan
Kharbanda, Mohit
Rajhans, Prasad
Mehta, Yatin
Todi, Subhash Kumar
Basu, Sushmita
Sahu, Suneeta
Mishra, Shakti Bedanta
Chawla, Rajesh
Nair, Pravin K.
Arjun, Rajalakshmi
Singla, Deepak
Sandhu, Kavita
Palaniswamy, Vijayanand
Bhakta, Arpita
Nor, Mohd Basri Mat
Chian-Wern, Tai
Bat-Erdene, Ider
Acharya, Subhash P.
Ikram, Aamer
Tumu, Nellie
Tao, Lili
Alvarez, Gustavo Andres
Valderrama-Beltran, Sandra Liliana
Jiménez-Alvarez, Luisa Fernanda
Henao-Rodas, Claudia Milena
Gomez, Katherine
Aguilar-Moreno, Lina Alejandra
Cano-Medina, Yuliana Andrea
Zuniga-Chavarria, Maria Adelia
Aguirre-Avalos, Guadalupe
Sassoe-Gonzalez, Alejandro
Aleman-Bocanegra, Mary Cruz
Hernandez-Chena, Blanca Estela
Villegas-Mota, Maria Isabel
Aguilar-De-Moros, Daisy
Castañeda-Sabogal, Alex
Medeiros, Eduardo Alexandrino
Dueñas, Lourdes
Carreazo, Nilton Yhuri
Salgado, Estuardo
Abdulaziz-Alkhawaja, Safaa
Agha, Hala Mounir
El-Kholy, Amani Ali
Daboor, Mohammad Abdellatif
Guclu, Ertugrul
Dursun, Oguz
Koksal, Iftihar
Havan, Merve
Ozturk-Deniz, Suna Secil
Yildizdas, Dincer
Okulu, Emel
Omar, Abeer Aly
Memish, Ziad A.
Janc, Jarosław
Hlinkova, Sona
Duszynska, Wieslawa
Horhat-Florin, George
Raka, Lul
Petrov, Michael M.
Jin, Zhilin
Issue Date
2024-05-04
Metadata
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Cambridge University Press CODEN ICEPEJournal
Infection Control and Hospital EpidemiologyDOI
10.1017/ice.2023.215Abstract
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.Type
info:eu-repo/semantics/articleRights
info:eu-repo/semantics/embargoedAccessLanguage
engISSN
0899823XEISSN
15596834ae974a485f413a2113503eed53cd6c53
10.1017/ice.2023.215
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