Mortality associated with nosocomial urinary-tract infection

Area of Science:

• Infectious Diseases
• Critical Care Medicine
• Epidemiology

Background:

• Indwelling bladder catheterization is a common procedure in hospitalized patients.
• Catheter-associated urinary tract infections (CAUTIs) are a significant source of hospital-acquired infections.
• The impact of CAUTIs on patient mortality requires further investigation.

Purpose of the Study:

• To prospectively assess the association between CAUTIs and mortality in hospitalized patients.
• To identify risk factors for mortality among patients with indwelling bladder catheters.
• To quantify the mortality risk attributable to CAUTIs.

Main Methods:

• Prospective study design involving 1458 patients undergoing catheterization.
• Monitoring for urinary tract infections (UTIs) defined as >10^5 CFU/mL.
• Statistical analysis using multiple logistic regression to determine mortality predictors.

Main Results:

• 131 patients (8.9%) acquired CAUTIs during 1474 catheterizations.
• Mortality rate was 19% in infected patients versus 4% in non-infected patients.
• CAUTI was associated with an adjusted odds ratio of 2.8 for mortality (95% CI, 1.5-5.1).

Conclusions:

• Acquisition of CAUTI is linked to a nearly threefold increase in mortality among hospitalized patients.
• The association between CAUTI and mortality was independent of underlying disease severity.
• Twelve deaths were potentially attributable to CAUTIs, underscoring their clinical significance.