Basics about the most common form of Healthcare-Associated Infections: CAUTI

May 2, 2010

Research has shown that the most common site for healthcare-associated infections is the urinary tract.  A study of U.S. acute care hospitals in 2002 found that urinary tract infections accounted for more than 30% of infections reported.

Urinary tract infections associated with healthcare are usually caused by some manner of instrumentation of the urinary tract.  Estimates show that indwelling urinary catheters are used for 15 to 25% of hospitalized patients.  As a result, find these types of infections are usually referred to as catheter-associated urinary tract infections or CAUTIs.

CAUTIs can cause blood stream infections.  In nursing homes, bacteremias are commonly a result of urinary tract infections, many of which are catheter related.

Morbidity and mortality associated with CAUTI is relatively low in comparison to other types of HAIs. However, the high prevalence of catheter use results in a large cumulative burden of infections with resulting complications and possibly death.  For example, in an estimate of annual incidence of HAIs and mortality in 2002 in U.S. hospitals, investigators revealed that urinary tract infections had the highest number of infections (over 560,000) compared to other HAIs; attributable deaths from these infections were estimated at over 13,000 resulting in a mortality rate of 2.3%.

References:

Edwards, J. R., Peterson, K. D., Andrus, M. L., Tolson, J. S., Goulding, J. S., Dudeck, M. A., et al. National healthcare safety network (NHSN) report, data summary for 2006, issued June 2007.  American Journal of Infection Control, 35(5): 290-301 (2007).

Gould, C. V., Umscheid, C. A., Agarwal, R. K., Kuntz, G., Pegues, D. A., & the Healthcare Infection Control Practices Advisory Committee (HICPAC).  Guideline for prevention of catheter-associated urinary tract infections 2009.  Healthcare Infection Control Practices Advisory Committee.  (2009).  Retrieved from http://www.cdc.gov/hicpac/pubs.html.

Klevens, R. M., Edwards, J. R., Richards, C. L., Horan, T. C. Gaynes, R. P., Pollock, D. A., Cardo, D. M.  (2007).  Estimating health care-associated infections and deaths in U.S. hospitals, 2002.  Public Health Reports, 122(2): 160-166 (2007).

Muder, R. R., Brennen, C., Wagener, M. M., & Goetz, A.  Bacteremia in a long-term-care facility: a five-year prospective study of 163 consecutive episodes.  Clinical Infectious Diseases, 14(3): 647-654 (1992).

U.S. Department of Health & Human Services.  Action Plan to Prevent Healthcare-Associated Infections.  (2009).

Warren, J. W.  Catheter-associated urinary tract infections.  International Journal of Antimicrobial Agents, 17(4): 299-303 (2001).

Weinstein, M. P., Towns, M. L., Quartey, S. M., Mirrett, S., Reimer, L. G., Parmigiani, G., et al.  The clinical significance of positive blood cultures in the 1990s: a prospective comprehensive evaluation of the microbiology, epidemiology, and outcome of bacteremia and fungemia in adults.  Clinical Infectious Diseases, 24(4): 584-602 (1997).

Weinstein, R. A., & Henderson, D. K. A double-edged sword and a golden opportunity for healthcare epidemiology.  Infection Control and Hospital Epidemiology, 30(1): 1-3 (2009).

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