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An Evaluation of Daily Bacteriologic Monitoring to Identify Preventable Episodes of Catheter-Associated Urinary Tract Infection

Published online by Cambridge University Press:  02 January 2015

Richard A. Garibaldi*
Affiliation:
Division of Infectious Diseases, University of Utah Medical Center, Salt Lake City, Utah
Barbara R. Mooney
Affiliation:
Division of Infectious Diseases, University of Utah Medical Center, Salt Lake City, Utah
Beverly J. Epstein
Affiliation:
Division of Infectious Diseases, University of Utah Medical Center, Salt Lake City, Utah
Michael R. Britt
Affiliation:
Division of Infectious Diseases, University of Utah Medical Center, Salt Lake City, Utah
*
Division of Infectious Diseases, University of Connecticut Health Center, Farmington, CT 06032

Abstract

We evaluated the efficacy of a daily bacteriologic monitoring program for preventing symptomatic urinary tract infections (UTI) in hospitalized patients with temporary indwelling urethral catheters. We identified 99 instances in which bacteriuria was present at the time of catheter insertion among 1,140 catheterizations. Of those, 62 patients were asymptomatic and 37 patients had fever or symptoms attributable to UTI. Of the 37 symptomatic episodes, only 14 developed symptoms 24 hours or more after the first culture and might be considered potentially preventable.

We also identified 76 episodes of acquired bacteriuria among 608 catheterizations that were initially non-bacteriuric in which at least two cultures were available. Of these 76 patients, 51 (67%) remained asymptomatic throughout their period of hospitalization. Of the 25 patients who developed symptomatic infections, only ten were potentially preventable.

In all, only 24 symptomatic episodes among 1,140 catheterizations (2%) occurred 24 hours or more after colonization was first detected and might be considered potentially preventable. Our data suggest that routine daily bacteriologic monitoring of urine from all catheterized patients is not an efficient way to decrease the incidence of symptomatic, catheter-associated UTI.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1982

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