Factors Affecting Urinary Tract Infection in Foley Catheter
Retained Patients in King Narai Hospital †
Kanjanawasri S, MD¹, Gulgusol N, MSc², Manapatanasatien T, MNS², Punjamawat A, Bsc³
Affiliation : ¹ Department of Medicine, King Narai Hospital, Lopburi, Thailand ² Department of Nursing Organization, King Narai Hospital, Lopburi, Thailand ³ Department of Microbiology, King Narai Hospital, Lopburi, Thailand
Background: Catheter associated urinary tract infection (CAUTI) is the most common infection in hospital and may cause other
complication that contribute to complexity and difficult treatment in addition to the increase of cost and longer hospital day.
Objective: 1) Determine the CAUTI occurrence rate, microorganism involved, and duration time to develop to CAUTI. 2) Analyze factors related to CAUTI among patient characteristics, underlying diseases, and abnormality of urinary tract. 3) Analyze risk factors related to CAUTI.
Materials and Methods: A prospective observational study of patients older than 15 years old who retained Foley catheter for more than two calendar days that were admitted at King Narai Hospital between April and July 2016 was done. Data were analyzed through descriptive and inferential statistics using SPSS program.
Results: Among 485 patients who retained Foley catheter for more than two calendar days, 269 patients were female (55.46%). Mean age was 64.75±16.68 years. Indication for retained Foley catheter were to monitor urine output in 65.15%, urinary retention in 12.58%, post operation in 7.42%, bed ridden in 4.54%, and bed sore in 5.98%. Mean duration time on Foley catheter was 16.81±14.96 days. Seventy-three patients had a history of prior admission within 60 days (15.05%). Out of 485 patients, 124 cases (25.57%) developed CAUTI. The incidence rate was 10.13 occurrence per 1,000 days. The incidence was 83 of 269 (30.86%) for women and 41 of 216 (18.98%) for men. Mean CAUTI detection was 9.87±11.62 days. The majority of CAUTI was caused by E. coli (ESBL) 31.45%, E. faecium 23.39%, P. aeruginosa (MDR) 13.75%, and K. pneumoniae (ESBL) 10.48%. The risk factors for CAUTI that were statistically significant were prior admission within 60 days (OR 3.38, 95% CI 2.31 to 4.89, p=0.005), duration time of retained Foley catheter (OR 2.03, 95% CI 1.47 to 3.46, p=0.008), using endotracheal tube (OR 2.83, 95% CI 0.44 to 4.38, p=0.006), female (OR 2.20, 95% CI 1.83 to 3.91, p=0.038), and CVA or bed ridden patients (OR 2.39, 95% CI 1.89 to 3.91, p=0.041).
Conclusion: The incidence rate of CAUTI in King Narai Hospital was 10.13 occurrence per 1,000 days. Female developed CAUTI 1.67 time more than male. The major organisms were E. coli (ESBL) 31.45% and E. faecium 23.39%. The risk factors of CAUTI were time on Foley catheter, prior admission within 60 days, using endotracheal tube, female, debility, and bed ridden patients.
Keywords : Catheter associated urinary tract infection (CAUTI), Risk factor, King Narai Hospital
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