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Bacteriologic surveillance of indwelling urinary catheters in pediatric intensive care unit patients
G F Kasian1, J H Elash, L K Tan
1Department of Pediatrics, University Hospital, University of Saskatchewan, Saskatoon, Canada.
Insights
Pediatric patients with indwelling urinary catheters face a significant risk of bacteriuria. Infants under one year old are at a higher risk for developing these urinary tract infections.
Area of Science:
- Pediatric Intensive Care Medicine
- Infectious Diseases
- Medical Device Associated Infections
Background:
- Urinary tract infections (UTIs) are common hospital-acquired infections.
- Indwelling urinary catheters are frequently used in pediatric intensive care units (PICUs).
- Catheter-associated bacteriuria is a significant concern in pediatric patients.
Purpose of the Study:
- To determine the risk of acquiring bacteriuria in pediatric intensive care unit (PICU) patients with indwelling urinary catheters.
- To compare the risk of bacteriuria between patients catheterized in the PICU versus the operating room.
- To identify risk factors associated with bacteriuria in this population.
Main Methods:
- Daily urine cultures were collected from the tubing port of 108 indwelling urinary catheters in 100 PICU patients (aged 1 month to 17 years).
- Patients were divided into two groups: Group 1 (catheterized in PICU) and Group 2 (catheterized in operating room).
- Statistical analysis was performed to compare bacteriuria rates and identify risk factors.
Main Results:
- Patients catheterized in the PICU (Group 1) had a higher early risk of bacteriuria compared to those catheterized in the operating room (Group 2) (p < .03).
- The final cumulative risk of bacteriuria was similar between groups (27% in Group 1, 37% in Group 2).
- The overall cumulative risk of bacteriuria was 29.1%.
- Risk of UTI was not associated with sex or prior antibiotic use.
- Children under 1 year of age had a significantly higher risk of bacteriuria (p < .025).
Conclusions:
- While initial bacteriuria risk differs based on catheterization location, the overall cumulative risk is comparable.
- Younger age (under 1 year) is a significant risk factor for bacteriuria in PICU patients with urinary catheters.
- These findings highlight the importance of vigilant catheter care and infection control in pediatric intensive care settings, particularly for infants.
Abstract:
Daily cultures were obtained from the proximal tubing port on 108 indwelling urinary catheters in 100 pediatric ICU (PICU) patients aged 1 month to 17 yr to establish the risk of acquiring bacteriuria. Group 1 patients (58 catheters) were catheterized in the PICU and group 2 patients (50 catheters) were catheterized in the operating room. Group 1 patients had a significantly (p less than .03) greater risk of bacteriuria than group 2 during the early days of surveillance, but the final cumulative risk in both groups was similar (27% in group 1 and 37% in group 2). Combined, the overall cumulative risk was 29.1%. The risk of acquiring a urinary tract infection was not related to sex or prior antibiotic use. There was a significantly greater risk (p less than .025) in children under 1 yr of age.