Prevalence of Catheter Associated-Urinary Tract Infections [CA-UTI] and the use of Foley catheters in a community hospital

Pranav Ghody, MD; Mointakhtar Lala, MD; Joshua Rosenberg, MD; Douglas Sepkowitz, MD Long Island College Hospital, Brooklyn, NY, USA Prevalence of Catheter Associated-Urinary Tract Infections [CA-UTI] and the use of Foley catheters in a community hospital Background: Studies have demonstrated the prevalence of CA-UTI at >30% of all Healthcare Associated Infections. Objective: To assess the use of foley catheters and determine the prevalence of CA-UTI in a community hospital setting in non-critical cares medical patients. Methods: Prospective observational study over a period of 4 months was carried out on all non critical medical patients. Checklists were designed to assess the usage, indications and continuation of foley catheters. Urinalysis, urine culture and antibiotic usages were followed. Results: 294 patients were followed over 4 months. 48 had catheters. Of these 48 patients, 8 patients presented to Emergency Room [ER] with catheters, 31 patients had catheters placed within 48hours of admission and 9 patients had catheters placed after 48 hours. No indications for catheter insertion were documented in 36 [75%] patients. The 9 patients who had catheters placed on medical floors had no documentation at all. Also, to assess catheter continuation, only 17 [35%] patients had indications. 6 patients acquired CA-UTI. We defined CA-UTI as positive urinalysis, urine culture and the use of antibiotic treatment. None of 6 patients who developed CA-UTI had any indications for catheter placement. Of the 6 patients who developed CA-UTI, 3 patients had catheter removed prior to discharge, 1 patient had catheter discontinued on discharge and 2 patients were discharged with catheters. Average duration of catheter was 2.41 days in patients with indications as compared to 5.58 days in patients without indications. In comparison, the number was 6.66 days in CA-UTI group. Average Length of stay was 4.54 for non-catheterized patients, 4 days for catheterized patients with indications and 13.08 in patients without indications. Similarly, Length of stay for patients in CA-UTI group was 22.84 days, however this data may have been skewed as length of stay for 1 of these patients was 67days. In our study, we recorded 26.08 CA-UTIs per 1000 catheter days. Conclusions: Even though it was a small study, we noticed some remarkable figures. Patients without documented indications had longer duration of catheters and subsequently longer hospital stays. Without documentation, patients tend to have catheters placed unnecessarily and often longer than required.