Protocolized Urine Sampling is Associated with Reduced Catheter-associated Urinary Tract Infections: A Pre- and Postintervention Study
| Autor: | Jennifer A. Frontera, Ting Zhou, Shadi Yaghi, Joseph Weisstuch, Stephanie Sterling, Archana Saxena, Michael Phillips, Erwin Wang, D. Ethan Kahn, Martha J. Radford, Karen Delorenzo, Aaron Lord |
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| Rok vydání: | 2020 |
| Předmět: |
Microbiology (medical)
medicine.medical_specialty Urinary system 030232 urology & nephrology Urine Urinary Catheters 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Humans 030212 general & internal medicine Device Removal business.industry Pyuria Catheter Infectious Diseases Catheter-Related Infections Urinary Tract Infections Propensity score matching Urine bacteria Cohort medicine.symptom Urinary Catheterization business Urine sample |
| Zdroj: | Clinical Infectious Diseases. 73:e2690-e2696 |
| ISSN: | 1537-6591 1058-4838 |
| Popis: | Background Standard urine sampling and testing techniques do not mitigate against detection of colonization, resulting in false positive catheter-associated urinary tract infections (CAUTI). We aimed to evaluate whether a novel protocol for urine sampling and testing reduces rates of CAUTI. Methods A preintervention and postintervention study with a contemporaneous control group was conducted at 2 campuses (test and control) of the same academic medical center. The test campus implemented a protocol requiring urinary catheter removal prior to urine sampling from a new catheter or sterile straight catheterization, along with urine bacteria and pyuria screening prior to culture. Primary outcomes were test campus CAUTI rates, compared between each 9-month pre- and postintervention epoch. Secondary outcomes included the percent reductions in CAUTI rates, compared between the test campus and a propensity score–matched cohort at the control campus. Results A total of 7991 patients from the test campus were included in the primary analysis, and 4264 were included in the propensity score–matched secondary analysis. In the primary analysis, the number of CAUTI cases per 1000 patients was reduced by 77% (6.6 to 1.5), the number of CAUTI cases per 1000 catheter days was reduced by 63% (5.9 to 2.2), and the number of urinary catheter days per patient was reduced by 37% (1.1 to 0.69; all P values ≤ .001). In the propensity score–matched analysis, the number of CAUTI cases per 1000 patients was reduced by 82% at the test campus, versus 57% at the control campus; the number of CAUTI cases per 1000 catheter days declined by 68% versus 57%, respectively; and the number of urinary catheter days per patient decreased by 44% versus 1%, respectively (all P values Conclusions Protocolized urine sampling and testing aimed at minimizing contamination by colonization was associated with significantly reduced CAUTI infection rates and urinary catheter days. |
| Databáze: | OpenAIRE |
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