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Published on: June 24, 2025
Risk Factors and Outcomes of Catheter-Associated Urinary Tract Infections in the Intensive Care Unit of a Tertiary
Ghada S K Mahran1,2, Ahmed A Jarelnape3, Tamer A T Dwairi2
1Department of Critical Care and Emergency Nursing, Faculty of Nursing, Assiut University, Assiut, Egypt.
Insights
Catheter-associated urinary tract infections (CAUTIs) are common in ICUs. Key risk factors include catheter duration, diabetes, and post-surgery status, necessitating targeted prevention strategies.
Area of Science:
- Critical Care Medicine
- Infectious Diseases
- Urology
Background:
- Catheter-associated urinary tract infections (CAUTIs) represent a significant healthcare challenge in intensive care units (ICUs).
- These infections are linked to prolonged hospital stays, increased healthcare costs, elevated antibiotic consumption, and higher mortality rates.
- Understanding CAUTI's incidence and risk factors in the ICU is crucial for effective patient management.
Purpose of the Study:
- To investigate the incidence, risk factors, causative pathogens, and outcomes of CAUTI in ICU patients at a tertiary university hospital.
- To identify specific patient demographics and clinical conditions associated with CAUTI development.
- To provide data that can inform targeted prevention strategies within the ICU setting.
Main Methods:
- A prospective study design was employed, enrolling adult patients with indwelling urinary catheters (IUCs) upon ICU admission.
- Patients were categorized into two groups: those who developed CAUTI and those who did not.
- Data collection focused on incidence, risk factors, pathogens, and patient outcomes related to CAUTI.
Main Results:
- The study enrolled 140 patients, with a CAUTI incidence of 43.5%.
- Significant risk factors identified included older age, female sex, smoking, post-surgery status, diabetes mellitus (DM), obstructive uropathy, immobility, and fecal incontinence.
- Cox regression analysis highlighted the duration of urinary catheterization (HR 7.14), DM (HR 6.25), and post-surgery status (HR 2.34) as the most significant predictors of CAUTI.
Conclusions:
- The incidence of CAUTI in the ICU setting is notably high.
- Identified risk factors such as older age, female sex, prolonged catheterization, DM, and post-surgery status require attention for prevention.
- Targeted preventive measures and ongoing education for healthcare workers are essential for reducing CAUTI in high-risk ICU patients.
Background:
Catheter-associated urinary tract infections (CAUTIs) are common among patients admitted to the intensive care unit (ICU). ICU-related CAUTI is associated with longer hospital stays, greater financial burden, greater antibiotic use and impact on mortality.
Aim:
This study aimed to address the incidence and risk factors, causative pathogens and outcomes of CAUTI among patients admitted to the ICU of a tertiary University Hospital.
Study Design:
This is a prospective study. All adult patients admitted to the ICU of a University Hospital who had indwelling urinary catheters (IUCs) at admission were included. Based on the occurrence of CAUTI, the study cohorts were divided into two groups: those with CAUTI and those without CAUTI. The incidence, risk factors, causative pathogens and the outcomes of patients with CAUTI were addressed.
Results:
One hundred and forty patients were enrolled, with a mean age of 43.84 ± 13.86 years, and 69/140 (49.3%) were male. The incidence of CAUTI was 43.5. CAUTI were significantly related to older age, female sex, smoking, post-surgery, diabetes mellitus (DM), obstructive uropathy, immobility, faecal incontinence and the duration of urinary catheterisation. Cox regression analysis revealed that the most significant risk factors for CAUTI were the duration of urinary catheterisation, DM and post-surgery, with hazard ratio of 7.14, 95% confidence interval (CI) 3.78-14.63, p < 0.001, 6.25, 95% CI 3.13-11.47, p < 0.001 and 2.34, 95% CI 1.23-4.45, p = 0.010, respectively.
Conclusions:
The current study shows that the incidence of CAUTI among ICU patients is high. Numerous risk factors for CAUTI were identified and included older age, female sex, longer duration of catheterisation, smoking, post-surgery, DM, obstructive uropathy and immobility. The most significant risk factors for CAUTI were the duration of urinary catheterisation, DM and post-surgery. Special precautions are needed to prevent CAUTI among ICU patients with those risk factors.
Relevance To Clinical Practice:
The results of this study will have implications for daily ICU practice. It is important to identify high-risk patients and consider targeted preventive measures. Ongoing education for healthcare workers on CAUTI prevention and management should be taken into account.
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