How Can We Reduce Device-Associated Urinary Tract Infections in Adult Intensive Care Units?

• Main Authors: Haluk ERDOĞAN, Aşkın ERDOĞAN, Hande ARSLAN
• Format: Article
• Language: English
• Published: Bilimsel Tip Yayinevi 2010-12-01
• Series: Flora Infeksiyon Hastalıkları ve Klinik Mikrobiyoloji Dergisi
• Subjects: Intensive care units; Cross infection; Urinary tract infections; Handwashing; Universal precautions
• Online Access: http://www.floradergisi.org/getFileContent.aspx?op=REDPDF&file_name=2010-15-4-160-164.pdf

Introduction: We found that the rate of our catheterization-related urinary tract infections was significantly higher than the intensive care unit data that were included in the American National Nosocomial Infections Surveillance System (NNIS) in 2003. In this study, we aimed to reduce the rates of device-associated uninary tract infections. Patients and Methods: The current study was conducted in three intensive care units with 15 beds in Baskent University Alanya Research and Application Center. The adult patients (older than 15 years of age) who were hospitalized in the intensive care unit between January 2003 and October 2005 were included in the study. NNIS criteria were used for diagnosis of nosocomial infections, and a patient-based prospective surveillance method was utilized. Infection control strategies for implementation and care of urinary catheterization were reviewed. Training was given to intensive care unit staff for implementation and care of urinary catheterization. Old-fashioned tap water faucets were replaced with electronic photocell operated new faucets for facilitating handwashing. Alcohol-based hand antiseptics were placed next to each patient; hence, more efficient use was obtained. Results: The rates of catheter use between 2003 and 2005 were 0.76, 0.76 and 0.79; catheter-associated urinary tract infections rates were 19.1, 13.6 and 4.8 per 1000 catheter days. When compared to the rates of 2003, the rates of urinary tract infections in 2005 were significantly reduced odds ratio= 4.0 (95% confidence interval: 1.5-10.6) (p= 0.004). Conclusion: Healthcare workers should be aware of the cross infections in patients with urinary catheterization. Hand hygiene, glove use and standard precautions are important in reducing catheter-associated urinary tract infections as well as in preventing accumulation.