Incidence of healthcare-associated urinary tract infections in Thai children.

Abstract

Urinary tract infection is one of the commonest types of healthcare-associated infections. There are currently limited data regarding the incidence and characteristics of healthcare-associated urinary tract infections (HA-UTIs) in children. This study was conducted to determine the incidence of HA-UTIs and their characteristics and associated risk factors. A case-control study was performed from 2016 to 2020 on children under 15 years old who were diagnosed with HA-UTI. Patients who had HA-UTI were compared with non-UTI patients. The incidence rate of HA-UTIs was calculated and reported as events per 1000 patient days. Potential associated risk factors were analyzed using multivariate logistic regression. Eighty cases and 80 controls were included in the study. The incidence of HA-UTIs was 0.32 events per 1000 patient days. The median time to UTI was 18 days. The most common causative organism was Escherichia coli (43.2%) and the rates of third-generation cephalosporin resistance and carbapenem resistance were 75.6% and 4.9%, respectively. Admission longer than 7 days (OR=21.61, 95% CI: 6.30-74.11; p < 0.001), neurogenic bladder (OR=26.24, 95% CI: 3.77-182.87; p < 0.001), mechanical ventilation (OR=3.60, 95% CI: 1.23-10.54; p=0.019), and immunosuppressants (OR=2.59; 95% CI: 1.01-6.60; p=0.047) were the risk factors significantly associated with HA-UTIs. The incidence of HA-UTIs was low in this single-center experience. Identifying patients with the risk factor is imperative for preventing the development of HA-UTIs.