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Risk Factors for Catheter-Associated Urinary Tract Infections (CA-UTI) in the Pediatric Intensive Care Unit
A V Lalitha1, Manisha Paul2, Savitha Nagraj2
1Department of Pediatric Intensive Care, St. John's Medical College and Hospital, Bengaluru, Karnataka. Correspondence to: Dr AV Lalitha, Department of Pediatric Intensive Care, St John's Medical College and Hospital, Bengaluru, Karnataka 560 034. drlalitha03@gmail.com.
Insights
Catheter-associated urinary tract infections (CA-UTI) are common in pediatric intensive care units (PICUs). Prolonged catheter use and extended hospital stays increase the risk of CA-UTI in critically ill children.
Area of Science:
- Pediatric critical care medicine
- Infectious diseases
- Nosocomial infections
Background:
- Catheter-associated urinary tract infections (CA-UTI) represent a significant nosocomial infection in pediatric intensive care units (PICUs).
- Understanding the epidemiology and risk factors of CA-UTI is crucial for developing effective prevention strategies in critically ill children.
Purpose of the Study:
- To delineate the incidence, microbiological profiles, and associated risk factors of CA-UTI in critically ill children.
- To identify key variables contributing to the development of CA-UTI in the PICU setting.
Main Methods:
- A retrospective review of hospital records was conducted for patients diagnosed with CA-UTI in the PICU between 2014 and 2020.
- Multivariate logistic regression analysis was employed to determine significant risk factors associated with CA-UTI.
Main Results:
- A total of 62 CA-UTI cases were identified, with an overall occurrence rate of 7.2 per 1000 catheter-days.
- Escherichia coli and Enterococcus faecalis were the predominant causative organisms.
- Significant risk factors included longer duration of catheter drainage, extended PICU stay, and prolonged hospital stay.
Conclusions:
- CA-UTI is a prevalent nosocomial infection within PICUs.
- The duration of urinary catheterization and the length of PICU and hospital stays are significant risk factors for CA-UTI in critically ill children.
Objective:
To describe the occurrence, microbiology, and risk factors of catheter- associated urinary tract infections (CA-UTI) in critically ill children.
Methods:
We conducted a review of hospital records for CA-UTI in the pediatric intensive care unit (PICU) over a 7-year period (2014-2020).
Results:
62 CA-UTI cases (48% boys, median (IQR) age 36 (12,96 month) were identified during the study period with occurrence rate of 7.2/1000 catheter-days. The most common organisms were Escherichia coli (32.4%) and Enterococcus faecalis (30.6%). Using a multivariate logistic regression analysis, the significant associated variables for CA-UTI were duration of catheter drainage (a OR (95% CI) 1.14, (1.03,1.27), P=-0.009), PICU stay (aOR (95% CI) 1.13 (1.05,1.21) (P<0.001), and hospital stay (aOR (95% CI): 1.03 (1.01,1.06), P=0.015).
Conclusion:
CA-UTI is not an uncommon nosocomial infection in PICU. The risk increases with increasing duration of catheter drainage, and hospital or PICU stay.
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