Catheter-Associated UTIs Raise Death Risk

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WASHINGTON, D.C.—Catheter-associated UTIs (CA-UTIs) significantly increase patients' risk of death, researchers have found.

Investigators at LDS Hospital in Salt Lake City used information from the hospital's Urinary Catheter Monitor Program to examine the relationship between CA-UTI and mortality. The program involves culture of daily urine collections from all catheterized patients. The researchers studied 26,596 patients who had indwelling uretheral catheters, following them until discharge, death, or catheter removal.

Enrollment criteria included no detectable bacteriuria at catheter insertion and a hospital stay of least four days. All clinical and demographic data were abstracted from the electronic medical record. 

The overall incidence of CA-UTI was 9.1 episodes per 1,000 catheterized patient-days, reported study investigator Kristin Dascomb, MD, PhD, assistant professor of infectious diseases at LDS.

After controlling for ICU stay, age, and occurrence of nosocomial bacteremia, the researchers estimated the odds ratio for death from CA-UTI to be 1.37 compared with catheterized patients without CA-UTI. Among patients who died, 8.9% had bacteriuria and 1.5% had a urine culture positive on the last day of catheterization.

“Trying to take out urinary catheters as early as possible may help decrease overall mortality in the long run,” said Dr. Dascomb, who reported findings here at a joint meeting of the Interscience Conference on Antimicrobial Agents and Chemotherapy and the Infectious Diseases Society of America.

The study is unique in that all patients had a catheter, whereas previous studies compared patients with and without catheters, she said. And even though the study is limited by its retrospective design, she noted, it provides what may be the best information available on this subject because of the intensive tracking and culture monitoring in thousands of catheterized patients.

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