Analysis of risk factors for urinary catheter-associated urinary tract infections in patients in aged intensive care unit

Abstract

Objectives To investigate the risk factors associated with catheter-associated urinary tract infections(CAUTIs)in patients in aged intensive care unit(ICU). Methods 226 cases of patients over 65 years old with CAUTIs in aged ICU from December 2013 to September 2015 were retrospectively analyzed.CAUTIs occurred in 49 cases, with an average age of(84±6.8)years, ranging from 65 to 101 years.The clinical data were collected and risk factors for CAUTIs were explored. Results Among all 226 cases, the average length of stay in intensive care unit was(38.6±48.4)days.The mean number of hospital days were(88.7±101.8)days.The average acute physiology and chronic health evaluation(APACHE)Ⅱ score was 22.9±7.6 on admission to ICU.Rate of anus swabs(P<0.05), transfusion(P<0.01), intensive care unit length of stay(P<0.05)coloclysis(P<0.05), bladder irrigation(P<0.01), catheterization(P<0.01), indwelling catheter time(P<0.01), duration of mechanical ventilation(P<0.01), and gastrointestinal decompression(P<0.01)were all higher in patients with CAUTIs than in CAUTIs-free patients(P<0.05). Multivariable logistic regression analysis showed that age(P<0.01), bladder irrigation(P<0.05), mechanical ventilation(P<0.01)and gastrointestinal decompression(P<0.05)were the risk factors for CAUTIs(P<0.05). And according to COX regression analysis, the intensive care unit length of stay(P<0.01), transfusion(P=0.002), indwelling catheter time(P<0.01), catheterization(P<0.05)and mechanical ventilation(P<0.01)remained significantly associated with patient survival time. Conclusions Age, bladder irrigation, mechanical ventilation and gastrointestinal decompression are risk factors for CAUTIs.The incidence of urinary tract infection is increased with ageing.Morbidity of CAUTIs is increased when length of stay in intensive care unit is more than 90 days and mechanical ventilation time is more than 90 days. Key words: Urinary catheterization; Urinary tract infections; Risk factors