Japanese Society for Infection Prevention and Control-Online Journal

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Incidence of Catheter-associated Urinary Tract Infections and the Appropriate Use of Urinary Catheters in General Wards: A Retrospective Cohort Study

Naomi KAYAUCHI¹⁾, Mikiro KATO²⁾³⁾ and Tomoko SAKIHAMA⁴⁾
¹⁾Department of Infection Control, Mito Kyodo General Hospital, University of Tsukuba, ²⁾Department of Infectious Diseases, University of Tsukuba Hospital, ³⁾Department of Infectious Diseases, Mito Kyodo General Hospital, University of Tsukuba, ⁴⁾Department of Nursing, University of Seitoku

We conducted a retrospective cohort study about the incidence of catheter-associated urinary tract infections (CAUTI) and a survey on appropriate urinary catheter use in a single acute care hospital. This study included 606 patients who underwent catheter placement after admission and were managed in general wards from April 2017 to December 2018. CAUTI occurred in 19 patients, with an incidence rate of 4.1/1000 device days. The univariate analysis revealed "chronic heart failure," "bedridden," "prolonged catheter use,"and "open irrigation" as causal risk factors for CAUTI. In the survey of catheter use, only 43.4% of catheters were placed for the appropriate reasons. After the catheter placement, the rate of appropriate use decreased weekly to 38.1%, 35.9%, 34.3%, and 33.3%. CAUTI developed in 3 out of 11 patients after open irrigation (p < 0.01). After removing the catheter, voiding support was not appropriately provided to 30 patients (38.0%) and 26 patients required catheters again. Fourteen patients were discharged without catheter removal. To reduce CAUTI, health care teams need to improve implementation of care bundles, such as adherence to catheter insertion protocol, shortening catheter placement, maintaining a closed system, introduction of portable bladder scanner, and strengthening a urinary support team.

Key words：catheter-associated urinary tract infections, appropriate use of the urinary catheter, urinary catheter life cycle

e-mail: k.mikiro＠gmail.com

Received: May 13, 2021
Accepted: February 19, 2022

37 (3)：69─77,2022