Abstract P-455: CATHETER ASSOCIATED URINARY TRACT INFECTIONS (CA-UTI): WHAT’S THE BIG DEAL?

Abstract

Aims & Objectives: To review the incidence of CA-UTI, preventable factors and staff understanding in children admitted to PICU Methods Analysis of all cases of CA UTI over a 5 year period – January 2013-December 2017, in children admitted to PICU, looking at causes, outcomes and preventability. Cases are referred clinically and by review of the microbiology database at the monthly multidisciplinary HCAI meetings. Results 50 cases were identified in 48 children – 2 had recurrent infections. This equated to an overall 6 year rate of 2.4/1000 urinary catheter (UC) days – however this rate has risen significantly in the last 2 years. CA –UTI were the commonest HCAI in our PICU during this time period. 8 (16%) infections were associated with positive blood cultures. 2 of these children became significantly more unwell in relation to this blood stream infection, requiring escalation of ventilation and inotropic support. 10 (20%) children died but the infection was not related to death in any. 35 (70%) were considered preventable on analysis: these were children who either did not require a UC for their management or in whom the UC was left in when the child’s clinical condition had improved. Ongoing staff discussion and education identified lack of knowledge regarding risk of CA-UTI, limited care bundle documentation and failure to review the need for a UC.Conclusions CA-UTI are not benign and the majority are preventable. Greater awareness and early removal of catheters could significantly impact on infection rates and resultant antibiotic exposure