A bundle-based approach on catheter-associated urinary tract infection: a multi-center study in Chinese tertiary hospitals

Abstract

Background: Catheter-associated urinary tract infections (CAUTIs) are one of the most common types of healthcare-associated infections (HAIs). Current studies mainly focus on risk factors, but the method to control them is unresolved. We aim to give an overview of the epidemiology of CAUTIs and explore the effects of bundle intervention on intensive care unit (ICU) inpatients. Methods: A multi-center, double-blind, retrospective study was conducted in eight Xiamen medical centers over six months; we recruited ICU inpatients with indwelling urinary catheters (UC) > = 48 h. Data were analyzed using Chi-Square and student’s t-test. Results: With bundle interventions, the CAUTI rate in ICUs decreased from 3.84 to 1.31 per 1000 UC days. The UC utilization was significantly reduced after bundles (71.29–62.70%), and the average duration of indwelling UC was reduced considerably (7,035 days vs. 6,884 days). CAUTIs in patients over 60 years old were significantly reduced after bundles. There were 45 causative organisms detected from 36 cases of CAUTIs, including 12 multidrug-resistant bacteria. Conclusions: Bundles have been shown to reduce the risk of CAUTIs in patients with indwelling catheters in the ICU, especially older adults. It also significantly reduces the use of Carbapenem. Therefore, CAUTI bundles are recommended to clinicians.