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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

  • Victor Daniel Rosenthal
  • , Ruijie Yin
  • , Eric Christopher Brown
  • , Brandon Hochahn Lee
  • , Camilla Rodrigues
  • , Sheila Nainan Myatra
  • , Mohit Kharbanda
  • , Prasad Rajhans
  • , Yatin Mehta
  • , Subhash Kumar Todi
  • , Sushmita Basu
  • , Suneeta Sahu
  • , Shakti Bedanta Mishra
  • , Rajesh Chawla
  • , Pravin K. Nair
  • , Rajalakshmi Arjun
  • , Deepak Singla
  • , Kavita Sandhu
  • , Vijayanand Palaniswamy
  • , Arpita Bhakta
  • Mohd Basri Mat Nor, Tai Chian-Wern, Ider Bat-Erdene, Subhash P. Acharya, Aamer Ikram, Nellie Tumu, Lili Tao, Gustavo Andres Alvarez, Sandra Liliana Valderrama-Beltran, Luisa Fernanda Jiménez-Alvarez, Claudia Milena Henao-Rodas, Katherine Gomez, Lina Alejandra Aguilar-Moreno, Yuliana Andrea Cano-Medina, Maria Adelia Zuniga-Chavarria, Guadalupe Aguirre-Avalos, Alejandro Sassoe-Gonzalez, Mary Cruz Aleman-Bocanegra, Blanca Estela Hernandez-Chena, Maria Isabel Villegas-Mota, Daisy Aguilar-De-Moros, Alex Castañeda-Sabogal, Eduardo Alexandrino Medeiros, Lourdes Dueñas, Nilton Yhuri Carreazo, Estuardo Salgado, Safaa Abdulaziz-Alkhawaja, Hala Mounir Agha, Amani Ali El-Kholy, Mohammad Abdellatif Daboor, Ertugrul Guclu, Oguz Dursun, Iftihar Koksal, Merve Havan, Suna Secil Ozturk-Deniz, Dincer Yildizdas, Emel Okulu, Abeer Aly Omar, Ziad A. Memish, Jarosław Janc, Sona Hlinkova, Wieslawa Duszynska, George Horhat-Florin, Lul Raka, Michael M. Petrov, Zhilin Jin
  • University of Miami
  • INICC Foundation
  • P.D. Hinduja National Hospital and Medical Research Centre
  • Tata Memorial Hospital
  • Desun Hospital
  • Deenanath Mangeshkar Hospital and Research Center Erandwane Pune
  • Medanta (The Medicity)
  • Mukundapur Unit
  • Advanced Medicare Research Institute Dhakuria Unit
  • Apollo Hospital Bhubaneswar
  • IMS And SUM Hospital
  • Apollo Hospitals Group
  • Holy Spirit Hospital
  • Kerala Institute of Medical Sciences
  • Maharaja Agrasen Hospital
  • Max Super Speciality Hospital Saket Delhi
  • Mahatma Gandhi Hospital
  • University Malaya Medical Centre
  • International Islamic University Malaysia
  • Universiti Kebangsaan Malaysia
  • Intermed Hospital
  • Grande International Hospital
  • Armed Forces Institute of Urology
  • Port Moresby General Hospital
  • Fudan University
  • Instituto Central de Medicina
  • Pontificia Universidad Javeriana
  • Clinica Universitaria Colombia
  • Fundacion Hospital San Jose De Buga
  • Clinica Sebastian de Belalcazar
  • Clinica Infantil Santa María del Lago
  • Instituto Del Corazon De Bucaramanga Sede Bogota
  • Hospital Clinica Biblica
  • Universidad de Guadalajara
  • Hospital Regional de Alta Especialidad Ixtapaluca
  • Hospital San Jose TecSalud
  • Hospital General Regional 6 De Ciudad Madero
  • Instituto Nacional de Perinatologia
  • Hospital del Niño Dr. José Renán Esquivel
  • Hospital Victor Lazarte Echegaray
  • Universidade Federal de São Paulo
  • Hospital Nacional de Niños Benjamin Bloom
  • Hospital Marie Curie
  • Salmaniya Medical Complex
  • Cairo University
  • King Hussein Cancer Center
  • Sakarya University Training and Research Hospital
  • Akdeniz University
  • Karadeniz Technical University
  • Ankara University Faculty of Medicine Childrens Hospital NICU
  • Pamukkale University Hospital
  • Balcali Hospital Pediatric Intensive Care Unit
  • Ministry of Health, Kuwait
  • Ministry of Health, Saudi Arabia
  • Wrocław Military Hospital
  • Catholic University in Ruzomberok Faculty of Health Central Military Hospital Snp Ruzomberok
  • Wrocław Medical University
  • Victor Babes University of Medicine and Pharmacy
  • National Institute for Public Health
  • Medical University of Plovdiv

Research output: Contribution to journalArticlepeer-review

16 Scopus citations

Abstract

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.

Original languageEnglish
Pages (from-to)567-575
Number of pages9
JournalInfection Control and Hospital Epidemiology
Volume45
Issue number5
DOIs
StatePublished - 4 May 2024

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

  1. SDG 3 - Good Health and Well-being
    SDG 3 Good Health and Well-being

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