Risk Factors for Catheter Associated Urinary Tract Infections in a Pediatric Institution

No AccessJournal of UrologyUrinary Tract Infection/Vesicoureteral Reflux1 Apr 2016Risk Factors for Catheter Associated Urinary Tract Infections in a Pediatric Institution Nora G. Lee, Daniel Marchalik, Andrew Lipsky, H. Gil Rushton, Hans G. Pohl, and Xiaoyan Song Nora G. LeeNora G. Lee Division of Urology, Children’s National Medical Center, Washington, D.C. More articles by this author , Daniel MarchalikDaniel Marchalik Division of Urology, Children’s National Medical Center, Washington, D.C. More articles by this author , Andrew LipskyAndrew Lipsky Department of Internal Medicine, Montefiore Medical Center, New York, New York More articles by this author , H. Gil RushtonH. Gil Rushton Division of Urology, Children’s National Medical Center, Washington, D.C. More articles by this author , Hans G. PohlHans G. Pohl Division of Urology, Children’s National Medical Center, Washington, D.C. More articles by this author , and Xiaoyan SongXiaoyan Song Division of Infectious Diseases, Children’s National Medical Center, Washington, D.C. More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.03.121AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Catheter associated urinary tract infections are an essential measure for health care quality improvement that affects reimbursement through hospital acquired condition reduction programs in adult patients. With the mounting importance of preventing such infections we evaluated risk factors for acquiring catheter associated urinary tract infections in pediatric patients. Materials and Methods: All catheter associated urinary tract infections were identified at 1 pediatric institution from September 2010 to August 2014 from a prospective database maintained by the infection control office. To identify risk factors patients with a catheter associated urinary tract infection were individually matched to control patients with a urinary catheter but without infection by age, gender, date and the hospital location of the infection in 1:2 fashion. Results: A total of 50 patients with catheter associated urinary tract infection were identified and matched to 100 control patients. Compared to controls the patients with infection were more likely to have a catheter in place for longer (2.9 days, OR 1.08, 95% CI 1.01, 1.15, p = 0.02). They were also more likely to be on contact precautions (OR 4.00, 95% CI 1.73, 9.26, p = 0.001), and have concurrent infections (OR 3.04, 95% CI 1.39, 6.28, p = 0.005) and a history of catheterization (OR 3.24, 95% CI 1.55, 6.77, p = 0.002). Using a conditional multivariate regression model the 3 most predictive variables were duration of catheter drainage, contact isolation status and history of catheterization. Conclusions: Longer duration of urinary catheter drainage, positive contact precautions status and a history of catheterization appear to be associated with a higher risk of catheter associated urinary tract infection in hospitalized pediatric patients. Physicians should attempt to decrease the duration of catheterization, especially in patients who meet these criteria, to minimize the risk of catheter associated urinary tract infection. References 1 : Indwelling urinary catheter management and catheter-associated urinary tract infection prevention practices in Nurses Improving Care for Healthsystem Elders hospitals. Am J Infect Control2012; 40: 715. Google Scholar 2 : Effect of nonpayment for hospital-acquired, catheter-associated urinary tract infection: a statewide analysis. Ann Intern Med2012; 157: 305. 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Linthicum: American Urological Association2014. Google Scholar © 2016 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 195Issue 4 Part 2April 2016Page: 1306-1311 Advertisement Copyright & Permissions© 2016 by American Urological Association Education and Research, Inc.Keywordshospitalsurinary tract infectionsriskcatheterizationcross infectionMetricsAuthor Information Nora G. Lee Division of Urology, Children’s National Medical Center, Washington, D.C. More articles by this author Daniel Marchalik Division of Urology, Children’s National Medical Center, Washington, D.C. More articles by this author Andrew Lipsky Department of Internal Medicine, Montefiore Medical Center, New York, New York More articles by this author H. Gil Rushton Division of Urology, Children’s National Medical Center, Washington, D.C. More articles by this author Hans G. Pohl Division of Urology, Children’s National Medical Center, Washington, D.C. More articles by this author Xiaoyan Song Division of Infectious Diseases, Children’s National Medical Center, Washington, D.C. More articles by this author Expand All Advertisement PDF downloadLoading ...