Urethral catheter-related urinary infection in critical patients admitted to the ICU. Descriptive data of the ENVIN-UCI STUDY

Abstract

ObjectiveTo describe trends in national catheter-related urinary tract infection (CRUTI) rates, as well as etiologies and multiresistance markers. DesignAn observational, prospective, multicenter voluntary participation study was conducted from 1 April to 30 June in the period between 2005 and 2010. SettingIntensive Care Units (ICUs) that participated in the ENVIN-ICU registry during the study period. PatientsWe included all patients admitted to the participating ICUs and patients with urinary catheter placement for more than 24h (78,863 patients). InterventionPatient monitoring was continued until discharge from the ICU or up to 60 days. Variables of interestCRUTIs were defined according to the CDC system, and frequency is expressed as incidence density (ID) in relation to the number of urinary catheter-patients days. ResultsA total of 2329 patients (2.95%) developed one or more CRUTI. The ID decreased from 6.69 to 4.18 episodes per 1000 days of urinary catheter between 2005 and 2010 (p<0.001). In relation to the underlying etiology, gramnegative bacilli predominated (55.6–61.6%), followed by fungi (18.7–25.2%) and grampositive cocci (17.1–25.9%). In 2010, ciprofloxacin-resistant Escherichia coli strains (37.1%) increased, as well as imipenem-resistant (36.4%) and ciprofloxacin-resistant (37.1%) strains of Pseudomonas aeruginosa. ConclusionsA decrease was observed in CRUTI rates, maintaining the same etiological distribution and showing increased resistances in gramnegative pathogens, especially E. coli and P. aeruginosa.