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

• Autores: Yin, Ruijie, Jin, Zhilin, Lee, Brandon Hochahn, Alvarez, Gustavo Andres, Stagnaro, Juan Pablo, Valderrama-Beltran, Sandra Liliana, Gualtero, Sandra Milena, Jiménez-Alvarez, Luisa Fernanda, Reyes, Lidia Patricia, Henao Rodas, Claudia Milena, Gomez, Katherine, Alarcon, Johana, Aguilar Moreno, Lina Alejandra, Bravo Ojeda, Juan Sebastian, Cano Medina, Yuliana Andrea, Chapeta Parada, Edwin Giovannny, Zuniga Chavarria, Maria Adelia, Quesada Mora, Ana Marcela, Aguirre-Avalos, Guadalupe, Mijangos-Méndez, Julio Cesar, Sassoe-Gonzalez, Alejandro, Millán-Castillo, Claudia Marisol, Aleman-Bocanegra, Mary Cruz, Echazarreta-Martínez, Clara Veronica, Hernandez-Chena, Blanca Estela, Jarad, Rajab Mohamed Abu, Villegas-Mota, Maria Isabel, Montoya-Malváez, Mildred, Aguilar-de-Moros, Daisy, Castaño-Guerra, Elizabeth, Córdoba, Judith, Castañeda-Sabogal, Alex, Medeiros, Eduardo Alexandrino, Fram, Dayana, Dueñas, Lourdes, Carreazo, Nilton Yhuri, Salgado, Estuardo, Rosenthal, Victor Daniel
• Formato: artículo
• Fecha de Publicación: 2023
• Institución: Universidad Peruana de Ciencias Aplicadas
• Repositorio: UPC-Institucional
• Lenguaje: inglés
• OAI Identifier: oai:repositorioacademico.upc.edu.pe:10757/673131
• Enlace del recurso: https://doi.org/10.1007/s00345-023-04645-z; http://hdl.handle.net/10757/673131
• Nivel de acceso: acceso embargado
• Materia: Catheter-associated urinary tract infections; Incidence; INICC; Intensive care units; Rates; Risk factors; https://purl.org/pe-repo/ocde/ford#3.00.00

Purpose: Identify urinary catheter (UC)-associated urinary tract infections (CAUTI) incidence and risk factors (RF) in Latin American Countries. Methods: 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. Results: 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. Conclusion: 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.