Current status of indwelling urinary catheter utilization and catheter-associated urinary tract infection throughout hospital wards in Korea: A multicenter prospective observational study

PLoS One. 2017 Oct 9;12(10):e0185369. doi: 10.1371/journal.pone.0185369. eCollection 2017.

Abstract

To evaluate the frequency and appropriateness of indwelling urinary catheters (IUC) use and the incidence of catheter-associated urinary tract infections (CA-UTI), and explore the risk factors for CA-UTI in hospitals as a whole, we conducted a study. This study was divided into two parts; a point-prevalence study on Dec 12th 2012 and a prospective cohort study from Dec 13th 2012 to Jan 9th 2013 were performed in six hospitals in Korea. All hospitalized patients with newly-placed IUCs were enrolled and monitored weekly for 28 days after IUC placement. In the point-prevalence study, the IUCs were present in median 14.9/100 hospitalized patients (1Q 14, 3Q 16) across the six hospitals. In the prospective cohort study, the median IUC-days per patient was 5 (1Q 3, 3Q 10) and the median CA-UTI prevalence per 1,000 catheter days was 1.9 (1Q 0.7, 3Q 3.8) with significant inter-hospital variation. The proportion of patients with inappropriate IUC maintenance increased with number of IUC-days (8.5% on day 7, 9.4% on day 14, 16.3% on day 21, and 23.1% on day 28). Urinary output monitoring (23/36, 63.9%) was the most common indication for inappropriate use after 1 week of ICU placement. In multivariate analysis, IUC-days was significantly associated with the development of CA-UTI (odds ratio 1.122, 95% confidence interval 1.074-1.173, P< 0.001). IUC-days and CA-UTI rates vary between hospitals. IUC-days is a risk factor for CA-UTI, and is correlated with inappropriate use.

MeSH terms

  • Aged
  • Catheter-Related Infections / etiology*
  • Catheters, Indwelling / adverse effects*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Republic of Korea / epidemiology
  • Urinary Catheterization / adverse effects
  • Urinary Catheters / adverse effects*
  • Urinary Tract Infections / etiology*

Grants and funding

This work was supported by the research fund of Hanyang University (HY-2013). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.