Risk factors for catheter-associated urinary tract infection among hospitalized patients: A systematic review and meta-analysis of observational studies

J Adv Nurs. 2019 Mar;75(3):517-527. doi: 10.1111/jan.13863. Epub 2018 Dec 21.

Abstract

Aims: The study aimed to identify the risk factors for catheter-associated urinary tract infection among hospitalized patients. We also tried to explore its potential effect on patient outcomes if possible.

Background: Catheter-associated urinary tract infection accounts for a large proportion of healthcare-associated infections and remains a considerable threat to patient safety worldwide.

Design: A systematic review and meta-analysis of observational studies.

Data sources: We conducted an electronic search in PubMed, EMBASE, Web of Science, and the Cochrane Database of Systematic Reviews for studies published between January 2008-January 2018.

Review methods: Two reviewers searched the articles and extracted the data independently. The quality of the studies was assessed with the Newcastle-Ottawa Scale. RevMan 5.3 was used to perform the meta-analysis.

Results: Ten studies involving a total of 8785 participants with or without catheter-associated urinary tract infection were included. The average incidence of catheter-associated urinary tract infection was 13.79 per 1000 catheter days, with a prevalence rate of 9.33%. The meta-analysis demonstrated that patients at high risk for catheter-associated urinary tract infection were female, had a prolonged duration of catheterization, had diabetes, had previous catheterization, and had longer hospital and ICU stays. Additionally, catheter-associated urinary tract infection was also accompanied by an increase in mortality.

Conclusions: Healthcare staff should focus on the identified risk factors for catheter-associated urinary tract infection. Further research is needed to investigate the microbial isolates and focus on the intervention strategies of catheter-associated urinary tract infection, so as to reduce its incidence and related mortality.

Keywords: catheter-associated urinary tract infection; hospitalized; meta-analysis; nursing; observational studies; risk factors; systematic review.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cross Infection / drug therapy*
  • Cross Infection / etiology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Risk Factors
  • Urinary Catheterization / adverse effects*
  • Urinary Tract Infections / drug therapy*
  • Urinary Tract Infections / etiology*