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Risk factors associated with urinary tract infections in intensive care patients

  • Author Footnotes
    1 Current affiliation: Senior Consultant, Alexandra Hospital. Intensive Care Medicine Department. 378 Alexandra Road, Singapore.
    Eng Kiang Lee
    Footnotes
    1 Current affiliation: Senior Consultant, Alexandra Hospital. Intensive Care Medicine Department. 378 Alexandra Road, Singapore.
    Affiliations
    Intensive Care Unit, Alfred Hospital, Melbourne, Victoria, Australia
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  • Author Footnotes
    2 Current affiliation: Intensivist/Anaesthetist, Mount Elizabeth Hospital; National University Hospital; Jurong Health Services; Changi General Hospital, Singapore.
    Alvin Teo
    Footnotes
    2 Current affiliation: Intensivist/Anaesthetist, Mount Elizabeth Hospital; National University Hospital; Jurong Health Services; Changi General Hospital, Singapore.
    Affiliations
    Intensive Care Unit, Alfred Hospital, Melbourne, Victoria, Australia
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  • Gillian Land
    Affiliations
    Infection Prevention and Healthcare Epidemiology Unit, Alfred Health, Melbourne, Victoria, Australia
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  • Sue Borrell
    Affiliations
    Infection Prevention and Healthcare Epidemiology Unit, Alfred Health, Melbourne, Victoria, Australia
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  • Denis Spelman
    Affiliations
    Department of Infectious Diseases, Alfred Hospital, Melbourne, Victoria, Australia
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  • Tim Leong
    Affiliations
    Intensive Care Unit, Alfred Hospital, Melbourne, Victoria, Australia
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  • Allen C. Cheng
    Correspondence
    Corresponding author. 2nd floor, Burnet Centre, Commercial Road, Melbourne, VIC, 3004, Australia.
    Affiliations
    Infection Prevention and Healthcare Epidemiology Unit, Alfred Health, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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  • Author Footnotes
    1 Current affiliation: Senior Consultant, Alexandra Hospital. Intensive Care Medicine Department. 378 Alexandra Road, Singapore.
    2 Current affiliation: Intensivist/Anaesthetist, Mount Elizabeth Hospital; National University Hospital; Jurong Health Services; Changi General Hospital, Singapore.

      Highlights

      • We aimed to determine risk factors for urinary tract infection (UTI) in ICU patients to inform potential interventions.
      • We compared 90 cases of UTIs with 90 patients with asymptomatic bacteriuria and 344 uninfected controls.
      • UTIs tended to occur early in the course of ICU admission, and were more common in surgical patients
      • Risk factors included catheter placement in emergency or the operating room.

      Abstract

      Introduction

      Urinary tract infections (UTI) are common in intensive care units (ICU) due to the high prevalence of urinary catheters. We aimed to determine risk factors for urinary tract infection to inform potential interventions to reduce this infection in ICU patients.

      Methods

      We performed a case-control-control study to determine risk factors for symptomatic UTIs, compared to asymptomatic bacteruria and control patients.

      Results

      We identified 90 patients with symptomatic urinary tract infections and 90 patients with asymptomatic bacteriuria, and 344 control patients without bacteriuria or urinary tract infection between January 2007 and August 2009. A higher proportion of patients with symptomatic UTIs had catheters placed in emergency or the operating theatres than in ICU. The risk of infection increased with increasing APACHE 2 score. The median duration of admission prior to symptomatic UTI was 6 days, and asymptomatic bacteriuria was 9 days.

      Discussion

      UTIs tended to occur early in the course of ICU admission, and were more common in surgical patients, particularly where the catheter was placed in emergency or the operating room.

      Keywords

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