Catheter-Associated Urinary Tract Infections, Bacteremia, and Infection Control Interventions in a Hospital: A Six-Year Time-Series Study

Amalia Papanikolopoulou; Helena C Maltezou; Athina Stoupis; Dimitra Kalimeri; Androula Pavli; Fotini Boufidou; Maria Karalexi; Nikos Pantazis; Constantinos Pantos; Yannis Tountas; Vasiliki Koumaki; Maria Kantzanou; Athanasios Tsakris

doi:10.3390/jcm11185418

Catheter-Associated Urinary Tract Infections, Bacteremia, and Infection Control Interventions in a Hospital: A Six-Year Time-Series Study

J Clin Med. 2022 Sep 15;11(18):5418. doi: 10.3390/jcm11185418.

Authors

Affiliations

¹ Clinical Pharmacology Department, Athens Medical Center, 5-7 Distomou Str., Marousi, 15125 Athens, Greece.
² Directorate of Research, Studies, and Documentation, National Public Health Organization, 3-5 AgrafonStr., Marousi, 15123 Athens, Greece.
³ Clinical Infectious Diseases Department, Athens Medical Center, 58 Kifissias Avenue, Marousi, 15125 Athens, Greece.
⁴ Nurse Department Athens Medical Center, 5-7 Distomou Str., Marousi, 15125 Athens, Greece.
⁵ Department of Travel Medicine, National Public Health Organization, 3-5 Agrafon Str., Marousi, 15123 Athens, Greece.
⁶ Neurochemistry and Biological Markers Unit, 1st Department of Neurology, School of Medicine, Eginition Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece.
⁷ Department of Microbiology, Faculty of Medicine, School of Health Sciences, National and Kapodistrian University of Athens, 75 Mikras Asias Str., 15772 Athens, Greece.
⁸ Department of Hygiene, Epidemiology and Medical Statistics, Faculty of Medicine, School of Health Sciences, National and Kapodistrian University of Athens, 75 Mikras Asias Str., 15772 Athens, Greece.
⁹ Department of Pharmacology, Faculty of Medicine, School of Health Sciences, National and Kapodistrian University of Athens, 75 Mikras Asias Str., 15772 Athens, Greece.

Abstract

Catheter-associated urinary tract infections (CAUTIs) are among the most common healthcare-associated infections. Urine catheters are often reservoirs of multidrug-resistant (MDR) bacteria and sources of pathogens transmission to other patients. The current study was conducted to investigate the correlation between CAUTIs, MDR bacteremia, and infection control interventions, in a tertiary-care hospital in Athens, from 2013 to 2018. The following data were analyzed per month: 1. CAUTI incidence; 2. consumption of hand hygiene disinfectants; 3. incidence of isolation of MDR carrier patients, and 4.incidence of bacteremia/1000 patient-days [total resistant a.Gram-negative: carbapenem-resistant Pseudomonas aeruginosa, Acinetobacter baumannii, and Klebsiella pneumoniae; b.Gram-positive: vancomycin-resistant Enterococci and methicillin-resistant Staphylococcus aureus]. The use of scrub disinfectant solutions was associated with decreased CAUTI rate in Total Hospital Clinics (OR: 0.97, 95% CI: 0.96−0.98, p-value: <0.001) and in Adults ICU (OR: 0.79, 95% CI: 0.65−0.96, p-value:0.018) while no correlation was found with isolation rate of MDR-carrier pathogens. Interestingly, an increase in total bacteremia (OR: 0.81, 95% CI: 0.75−0.87, p-value:<0.001) or carbapenem-resistant bacteremia correlated with decreased incidence of CAUTIs (OR: 0.96, 95% CI: 0.94−0.99, p-value: 0.008). Hand hygiene measures had a robust and constant effect on infection control, reducing the incidence of CAUTIs.

Keywords: catheter-associated urinary tract infection; healthcare-associated infections; infection control measures; multi-drug resistant bacteria; time series data.

Grants and funding

This research received no external funding.