Clinical and Economic Consequences of Catheter Urinary Tract Infections in Intensive Care Unit.

Background: The catheter-associated urinary tract infection (CA-UTI) is one of most common healthcare-associated infections in critical care setting. Aim: To determine the incidence rate, excess length of stay and excess antibiotics cost of patients with CA-UTIs. Methods: Α prospective observational study took place for one year period (January–December 2010) in two medical/surgical ICUs in Athens, Greece. Patient data included demographic characteristics, disease severity determined by the Acute Physiology and Chronic Health Evaluation (APACHE) II score on admission, co-morbidity determined by the weighted Charlson co-morbidity index on admission, date of CA-UTI onset, type and duration administrated antibiotics. Results: The incidence of UTI was 7.7% and the incidence density was 4.09 cases/1000 urinary catheter-days. The crude unadjusted attributable mortality was 22.8% among patients with CA-UTI and among patients with CA-UTI caused by Candida spp. The crude unadjusted attributable LOS was 8 days among patients with CA-UTI, while in patients with CA-UTI caused by P. aeruginosa was 36 days. The crude unadjusted attributable antibiotics cost was 1318€ among patients with CA-UTI and among patients with CA-UTI caused by P. aeruginosa was 5122€). Conclusion: Our study confirms the clinical and economic burden of CA-UTIs in ICU patients and highlights the establishing comprehensive education program for all healthcare workers on evidence-based approaches, and the implementation of urinary catheter bundle, which will contribute to reducing the burden of CA-UTIs and improving quality of care and patient safety in Greek ICUs.