An international prospective study of INICC analyzing the incidence and risk factors for catheter-associated urinary tract infections in 235 ICUs across 8 Asian Countries

Rosenthal, Victor D. and Yin, Ruijie and Abbo, Lilian M. and Lee, Brandon H. and Rodrigues, Camilla and Myatra, Sheila N. and Divatia, Jigeeshu Vasishtha and Kharbanda, Mohit and Nag, Bikas and Rajhans, Prasad and Shingte, Vasudha and Mehta, Yatin and Sarma, Smita and Todi, Subhash K. and Bhattacharyya, Mahuya and Basu, Sushmita and Sahu, Suneeta and Mishra, Shakti B. and Samal, Samir and Chawla, Rajesh and Jain, Aakanksha C. and Nair, Pravin K. and Kalapala, Durga and Arjun, Rajalakshmi and Singla, Deepak and Sandhu, Kavita and Badyal, Binesh and Palaniswamy, Vijayanand and Bhakta, Arpita and Gan, Chin S. and Mat Nor, Mohd Basri and Lai, Yin Hoong and Tai, Chian-Wern and Lee, Pei-Chuen and Bat-Erdene, Ider and Begzjav, Tsolmon and Acharya, Subhash P. and Dongol, Reshma and Ikram, Aamer and Tumu, Nellie and Tao, Lili and Jin, Zhilin (2024) An international prospective study of INICC analyzing the incidence and risk factors for catheter-associated urinary tract infections in 235 ICUs across 8 Asian Countries. American Journal of Infection Control, 52 (1). pp. 54-60. ISSN 0196-6553 E-ISSN 1527-3296

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Abstract

Background: Identify urinary catheter (UC)-associated urinary tract infections (CAUTI) incidence and risk factors (RF) in 235 ICUs in 8 Asian countries: India, Malaysia, Mongolia, Nepal, Pakistan, the Philippines, Thailand, and Vietnam. Methods: From January 1, 2014, to February 12, 2022, we conducted a prospective cohort study. To estimate CAUTI incidence, the number of UC days was the denominator, and CAUTI was the numerator. To estimate CAUTI RFs, we analyzed 11 variables using multiple logistic regression. Results: 84,920 patients hospitalized for 499,272 patient days acquired 869 CAUTIs. The pooled CAUTI rate per 1,000 UC-days was 3.08; for those using suprapubic-catheters (4.11); indwelling-catheters (2.65); trauma-ICU (10.55), neurologic-ICU (7.17), neurosurgical-ICU (5.28); in lower- middle-income countries (3.05); in upper-middle-income countries (1.71); at public-hospitals (5.98), at private-hospitals (3.09), at teaching-hospitals (2.04). The following variables were identified as CAUTI RFs: Age (adjusted odds ratio [aOR] = 1.01; 95% CI = 1.01-1.02; P < .0001); female sex (aOR = 1.39; 95% CI = 1.21-1.59; P < .0001); using suprapubic-catheter (aOR = 4.72; 95% CI = 1.69-13.21; P < .0001); length of stay before CAUTI acquisition (aOR = 1.04; 95% CI = 1.04-1.05; P < .0001); UC and device utilization-ratio (aOR = 1.07; 95% CI = 1.01-1.13; P = .02); hospitalized at trauma-ICU (aOR = 14.12; 95% CI = 4.68-42.67; P < .0001), neurologic-ICU (aOR = 14.13; 95% CI = 6.63-30.11; P < .0001), neurosurgical-ICU (aOR = 13.79; 95% CI = 6.88-27.64; P < .0001); public-facilities (aOR = 3.23; 95% CI = 2.34-4.46; P < .0001). Discussion: CAUTI rate and risk are higher for older patients, women, hospitalized at trauma-ICU, neurologic-ICU, neurosurgical-ICU, and public facilities. All of them are unlikely to change. Conclusions: It is suggested to focus on reducing the length of stay and the Urinary catheter device utilization ratio, avoiding suprapubic catheters, and implementing evidence-based CAUTI prevention recommendations.

Item Type:	Article (Journal)
Uncontrolled Keywords:	Rates
Subjects:	R Medicine > RC Internal medicine > RC82 Medical Emergencies, Critical Care, Intensive Care, First Aid
Kulliyyahs/Centres/Divisions/Institutes (Can select more than one option. Press CONTROL button):	Kulliyyah of Medicine Kulliyyah of Medicine > Department of Anaesthesiology & Intensive Care
Depositing User:	Dr. Mohd Basri Mat Nor
Date Deposited:	01 Feb 2024 15:38
Last Modified:	01 Feb 2024 15:46
URI:	http://irep.iium.edu.my/id/eprint/110652

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