Effect of a hospital-associated urinary tract infection reduction policy on general surgery patients

Background

Hospital-associated UTI rates in surgery patients have not improved despite recommendations for reducing indwelling catheter days.

Methods

We performed a retrospective review of institutional NSQIP general surgery patient data, 2006–2015. During this time, a UTI-reduction policy was implemented. Demographics, HA-UTI incidence, CA-UTI incidence, indwelling catheter days, straight catheterization rates, and mortality were examined.

Results

Females had significantly higher risk of HA-UTI. There was no significant change in HA-UTI (X12?=?0.02, p?=?.878) or indwelling catheter days (5.18?±?1.12 days v 3.73?±?0.39 days, p?=?.23). Straight catheterizations among those with HA-UTI increased (0.04?±?0.04 v 0.32?±?0.12, p?=?.029). There was no change in CA-UTI (1.38 v 1.11 CAUTI/1000 patient hospital-days P?=?.555) or in initial indwelling catheter days of patients with CA-UTI (7.2 SD 8.89 v 47.0 SD 7.04 days P?=?.961) after policy implementation.

Conclusions

The reduction policy increased the number of straight catheterizations for patients developing HA-UTI, but did not reduce the number of initial indwelling catheter days, HA-UTI rates, or CA-UTI rates.