55: REDUCING CAUTI EVENTS WITH ACTIVE DRAIN LINE CLEARANCE: A RETROSPECTIVE OBSERVATIONAL STUDY

Abstract

Introduction: Catheter-associated urinary tract infections (CAUTIs), represent approximately 9% of all hospital-associated infections and are associated with increased morbidity, mortality, and cost in intensive care units (ICUs). We performed a quality improvement study to assess if the use of a bladder catheter with integrated active drain line clearance reduced the rate of catheter-associated urinary tract infections (CAUTIs) in a burn ICU. Methods: We performed an eight-year (2015–2022) retrospective cohort study in a single-center burn ICU with seven beds. CAUTI events were compared from a 48-month period in which gravity bladder catheters had been the standard of care to a 28-month period after the implementation of a novel urinary catheter system. This urinary monitoring system features an active drain line clearance, two one-way valves preventing urinary backflow, and automation of intra-abdominal pressure measurements. Charts were reviewed to characterize the patients. Results: A total of 42 CAUTIs in 2243 patients were identified using the National Health and Safety Network (NHSN) definition during the analyzed period. The incidence of CAUTI events pre-implementation was 0.030 (mean 10 CAUTI events per year) compared to 0.002 (mean 1 CAUTI event per year) post-implementation of an automatic drain line clearing UO monitoring system showing a significant reduction in CAUTI events (P < 0.01, risk ratio Accuryn vs. no gravity bladder catheter 0.071, 95% confidence interval: 0.017-0.294). Median [IQR] urinary catheter dwell time to CAUTI events was 4.5 [2.0, 6.2] pre- and 6.0 [5.5, 6.5] post-novel catheter implementation. Conclusions: A novel urinary catheter system with integrated active drain line clearance reduced the rate of CAUTI after implementation. Active drain line clearance preventing standing urine in the bladder and tubing system and two one-way valves eliminating urine backflow might be favorable features potentially leading to a reduction in CAUTI events compared to gravity urinary catheters.