TY - JOUR
T1 - Prospective cohort study of incidence and risk factors for catheter-associated urinary tract infections in 145 intensive care units of 9 Latin American countries
T2 - INICC findings
AU - Yin, Ruijie
AU - Jin, Zhilin
AU - Lee, Brandon Hochahn
AU - Alvarez, Gustavo Andres
AU - Stagnaro, Juan Pablo
AU - Valderrama-Beltran, Sandra Liliana
AU - Gualtero, Sandra Milena
AU - Jiménez-Alvarez, Luisa Fernanda
AU - Reyes, Lidia Patricia
AU - Henao Rodas, Claudia Milena
AU - Gomez, Katherine
AU - Alarcon, Johana
AU - Aguilar Moreno, Lina Alejandra
AU - Bravo Ojeda, Juan Sebastian
AU - Cano Medina, Yuliana Andrea
AU - Chapeta Parada, Edwin Giovannny
AU - Zuniga Chavarria, Maria Adelia
AU - Quesada Mora, Ana Marcela
AU - Aguirre-Avalos, Guadalupe
AU - Mijangos-Méndez, Julio Cesar
AU - Sassoe-Gonzalez, Alejandro
AU - Millán-Castillo, Claudia Marisol
AU - Aleman-Bocanegra, Mary Cruz
AU - Echazarreta-Martínez, Clara Veronica
AU - Hernandez-Chena, Blanca Estela
AU - Jarad, Rajab Mohamed Abu
AU - Villegas-Mota, Maria Isabel
AU - Montoya-Malváez, Mildred
AU - Aguilar-de-Moros, Daisy
AU - Castaño-Guerra, Elizabeth
AU - Córdoba, Judith
AU - Castañeda-Sabogal, Alex
AU - Medeiros, Eduardo Alexandrino
AU - Fram, Dayana
AU - Dueñas, Lourdes
AU - Carreazo, Nilton Yhuri
AU - Salgado, Estuardo
AU - Rosenthal, Victor Daniel
N1 - Publisher Copyright:
© 2023, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
PY - 2023/12
Y1 - 2023/12
N2 - Purpose: Identify urinary catheter (UC)-associated urinary tract infections (CAUTI) incidence and risk factors (RF) in Latin American Countries. Methods: From 01/01/2014 to 02/10/2022, we conducted a prospective cohort study in 145 ICUs of 67 hospitals in 35 cities in nine Latin American countries: Argentina, Brazil, Colombia, Costa Rica, Dominican Republic, Ecuador, Mexico, Panama, and Peru. To estimate CAUTI incidence, we used the number of UC-days as the denominator, and the number of CAUTIs as numerator. To estimate CAUTI RFs, we analyzed the following 10 variables using multiple logistic regression: gender, age, length of stay (LOS) before CAUTI acquisition, UC-days before CAUTI acquisition, UC-device utilization (DU) ratio, UC-type, hospitalizationtype, ICU type, facility ownership, and time period. Results: 31,631 patients, hospitalized for 214,669 patient-days, acquired 305 CAUTIs. The pooled CAUTI rate per 1000 UC-days was 2.58, for those using suprapubic catheters, it was 2.99, and for those with indwelling catheters, it was 2.21. The following variables were independently associated with CAUTI: age, rising risk 1% yearly (aOR = 1.01; 95% CI 1.01–1.02; p < 0.0001 female gender (aOR = 1.28; 95% CI 1.01–1.61; p = 0.04), LOS before CAUTI acquisition, rising risk 7% daily (aOR = 1.07; 95% CI 1.06–1.08; p < 0.0001, UC/DU ratio (aOR = 1.14; 95% CI 1.08–1.21; p < 0.0001, public facilities (aOR = 2.89; 95% CI 1.75–4.49; p < 0.0001. The periods 2014–2016 and 2017–2019 had significantly higher risks than the period 2020–2022. Suprapubic catheters showed similar risks as indwelling catheters. Conclusion: The following CAUTI RFs are unlikely to change: age, gender, hospitalization type, and facility ownership. Based on these findings, it is suggested to focus on reducing LOS, UC/DU ratio, and implementing evidence-based CAUTI prevention recommendations.
AB - Purpose: Identify urinary catheter (UC)-associated urinary tract infections (CAUTI) incidence and risk factors (RF) in Latin American Countries. Methods: From 01/01/2014 to 02/10/2022, we conducted a prospective cohort study in 145 ICUs of 67 hospitals in 35 cities in nine Latin American countries: Argentina, Brazil, Colombia, Costa Rica, Dominican Republic, Ecuador, Mexico, Panama, and Peru. To estimate CAUTI incidence, we used the number of UC-days as the denominator, and the number of CAUTIs as numerator. To estimate CAUTI RFs, we analyzed the following 10 variables using multiple logistic regression: gender, age, length of stay (LOS) before CAUTI acquisition, UC-days before CAUTI acquisition, UC-device utilization (DU) ratio, UC-type, hospitalizationtype, ICU type, facility ownership, and time period. Results: 31,631 patients, hospitalized for 214,669 patient-days, acquired 305 CAUTIs. The pooled CAUTI rate per 1000 UC-days was 2.58, for those using suprapubic catheters, it was 2.99, and for those with indwelling catheters, it was 2.21. The following variables were independently associated with CAUTI: age, rising risk 1% yearly (aOR = 1.01; 95% CI 1.01–1.02; p < 0.0001 female gender (aOR = 1.28; 95% CI 1.01–1.61; p = 0.04), LOS before CAUTI acquisition, rising risk 7% daily (aOR = 1.07; 95% CI 1.06–1.08; p < 0.0001, UC/DU ratio (aOR = 1.14; 95% CI 1.08–1.21; p < 0.0001, public facilities (aOR = 2.89; 95% CI 1.75–4.49; p < 0.0001. The periods 2014–2016 and 2017–2019 had significantly higher risks than the period 2020–2022. Suprapubic catheters showed similar risks as indwelling catheters. Conclusion: The following CAUTI RFs are unlikely to change: age, gender, hospitalization type, and facility ownership. Based on these findings, it is suggested to focus on reducing LOS, UC/DU ratio, and implementing evidence-based CAUTI prevention recommendations.
KW - Catheter-associated urinary tract infections
KW - INICC
KW - Incidence
KW - Intensive care units
KW - Rates
KW - Risk factors
UR - https://www.scopus.com/pages/publications/85178205853
U2 - 10.1007/s00345-023-04645-z
DO - 10.1007/s00345-023-04645-z
M3 - Artículo
C2 - 37823942
AN - SCOPUS:85178205853
SN - 0724-4983
VL - 41
SP - 3599
EP - 3609
JO - World Journal of Urology
JF - World Journal of Urology
IS - 12
ER -