Prospective cohort study of incidence and risk factors for catheter-associated urinary tract infections in 145 intensive care units of 9 Latin American countries: INICC findings

• DOI: 10.1007/s00345-023-04645-z
• Publication Date: 2023-10-12T13:02:21Z
• Authors: Ruijie Yin; Zhilin Jin; Brandon Hochahn Lee; Gustavo Andres Al...; Juan Pablo Stagnaro; Sandra Liliana Va...; Sandra Milena Gua...; Luisa Fernanda Ji...; Lidia Patricia Reyes; Claudia Milena He...; Katherine Gomez; Johana Alarcon; Lina Alejandra Ag...; Juan Sebastian Br...; Yuliana Andrea Ca...; Edwin Giovannny C...; Maria Adelia Zuni...; Ana Marcela Quesa...; Guadalupe Aguirre...; Julio Cesar Mijan...; Alejandro Sassoe-...; Claudia Marisol M...; Mary Cruz Aleman-...; Clara Veronica Ec...; Blanca Estela Her...; Rajab Mohamed Abu...; Maria Isabel Vill...; Mildred Montoya-M...; Daisy Aguilar-de-...; Elizabeth Castaño...; Judith Córdoba; Alex Castañeda-Sa...; Eduardo Alexandri...; Dayana Fram; Lourdes Dueñas; Nilton Yhuri Carr...; Estuardo Salgado; Victor Daniel Ros...
• Keywords: Cross Infection; Intensive Care Units; Latin America; Catheters, Indwelling; Risk Factors; Catheter-Related Infections; Incidence; Urinary Tract Infections; Humans; Female; Prospective Studies; 3. Good health

Identify urinary catheter (UC)-associated urinary tract infections (CAUTI) incidence and risk factors (RF) in Latin American Countries.From 01/01/2014 to 02/10/2022, we conducted a prospective cohort study in 145 ICUs of 67 hospitals in 35 cities in nine Latin American countries: Argentina, Brazil, Colombia, Costa Rica, Dominican Republic, Ecuador, Mexico, Panama, and Peru. To estimate CAUTI incidence, we used the number of UC-days as the denominator, and the number of CAUTIs as numerator. To estimate CAUTI RFs, we analyzed the following 10 variables using multiple logistic regression: gender, age, length of stay (LOS) before CAUTI acquisition, UC-days before CAUTI acquisition, UC-device utilization (DU) ratio, UC-type, hospitalizationtype, ICU type, facility ownership, and time period.31,631 patients, hospitalized for 214,669 patient-days, acquired 305 CAUTIs. The pooled CAUTI rate per 1000 UC-days was 2.58, for those using suprapubic catheters, it was 2.99, and for those with indwelling catheters, it was 2.21. The following variables were independently associated with CAUTI: age, rising risk 1% yearly (aOR = 1.01; 95% CI 1.01-1.02; p < 0.0001 female gender (aOR = 1.28; 95% CI 1.01-1.61; p = 0.04), LOS before CAUTI acquisition, rising risk 7% daily (aOR = 1.07; 95% CI 1.06-1.08; p < 0.0001, UC/DU ratio (aOR = 1.14; 95% CI 1.08-1.21; p < 0.0001, public facilities (aOR = 2.89; 95% CI 1.75-4.49; p < 0.0001. The periods 2014-2016 and 2017-2019 had significantly higher risks than the period 2020-2022. Suprapubic catheters showed similar risks as indwelling catheters.The following CAUTI RFs are unlikely to change: age, gender, hospitalization type, and facility ownership. Based on these findings, it is suggested to focus on reducing LOS, UC/DU ratio, and implementing evidence-based CAUTI prevention recommendations.