Catheter-associated urinary tract infection and urinary catheter utilization ratio over 9 years, and the impact of the COVID-19 pandemic on the incidence of infection in medical and surgical wards in a single facility in Western Qatar

Humberto Guanche Garcell; Jameela Al-Ajmi; Ariadna Villanueva Arias; Joji C Abraham; Angel M Felipe Garmendia; Tania M Fernandez Hernandez

doi:10.5339/qmj.2023.14

Catheter-associated urinary tract infection and urinary catheter utilization ratio over 9 years, and the impact of the COVID-19 pandemic on the incidence of infection in medical and surgical wards in a single facility in Western Qatar

Qatar Med J. 2023 May 2;2023(1):14. doi: 10.5339/qmj.2023.14. eCollection 2023.

Authors

Humberto Guanche Garcell¹, Jameela Al-Ajmi², Ariadna Villanueva Arias¹, Joji C Abraham², Angel M Felipe Garmendia¹, Tania M Fernandez Hernandez¹

Affiliations

¹ Infection Control Department, The Cuban Hospital, Hamad Medical Corporation, Doha, Qatar. E-mail: humbertoguanchegarcell@yahoo.es ORCID: https://orcid.org/0000-0001-7279-0062.
² Corporate Infection Control Department, Hamad Medical Corporation, Doha, Qatar.

Abstract

Introduction: Catheter-associated urinary tract infection (CAUTI) is a frequently reported healthcare-associated infection in critical and non-critical patients. Limited data are available about CAUTI incidence in non-critical patients. We aim to describe the incidence of CAUTI over 9 years and evaluate the impact of the pandemic on the incidence in non-critical acute care patients.

Methods: A retrospective observational study of CAUTI in medical-surgical and maternity wards was carried out at a public hospital in the west of the State of Qatar. Data collected included the annual CAUTI incidence (per 1,000 device days), urinary catheter utilization ratio (UC-UR), etiology, and antimicrobial resistance.

Results: 115,238 patient days and 6,681 urinary catheters (UC) days were recorded over the study period, and 9 and 4 CAUTI were confirmed in medical-surgical and maternity wards, respectively. The infection rate was 1.9 per 1,000 UC days, and the UC-UR was 0.06. The CAUTI rate was higher in medical-surgical wards over the COVID-19 period (2.4 × 1,000 UC days) in comparison with the non-COVID-19 period (1.7 × 1,000 UC days) (RR 1.46; 1.12-1.80). However, in the maternity ward, the result was 0 and 2.5 × 1,000 UC days during these periods, respectively. No differences were observed in the infection rate among periods for all patients (RR 1.06; 0.81-1.31). Multidrug-resistant organisms were identified in 7 patients, and non-multidrug-resistant in 6 cases.

Conclusion: The study findings describe a lower CAUTI risk over 9 years in non-critical acute care patients. The impact of COVID-19 on the CAUTI risk is mainly related to medical patients who had previously been admitted to critical care. The infection control program should consider these data as a benchmark for quality improvement.

Keywords: COVID-19; Qatar; Urinary catheter; acute care; inpatient ward; the incidence of infection; urinary tract infection.