• Am J Infect Control · Dec 2011

    Preventing catheter-associated urinary tract infection in the zero-tolerance era.

    • Alexandre R Marra, Thiago Zinsly Sampaio Camargo, Priscila Gonçalves, Ana Maria Cristina B Sogayar, Denis Faria Moura, Luciana Reis Guastelli, Carla Andrea C Alves Rosa, Elivane da Silva Victor, Oscar Fernando Pavão Dos Santos, and Michael B Edmond.
    • Intensive Care Unit, Hospital Israelita Albert Einstein, São Paulo, Brazil. alexmarra@einstein.br
    • Am J Infect Control. 2011 Dec 1; 39 (10): 817-22.

    BackgroundCatheter-associated urinary tract infection (CAUTI) is one of the most common health care‒associated infections in the critical care setting.MethodsA quasi-experimental study involving multiple interventions to reduce the incidence of CAUTI was conducted in a medical-surgical intensive care unit (ICU) and in 2 step-down units (SDUs). Between June 2005 and December 2007 (phase 1), we implemented some Centers for Disease Control and Prevention‒recommended evidence-based practices. Between January 2008 and July 2010 (phase 2), we intervened to improve compliance with these practices at the same time that performance monitoring was being done at the bedside, and we implemented the Institute for Healthcare Improvement's bladder bundle for all ICU and SDU patients requiring urinary catheters.ResultsThere was a statistically significant reduction in the rate of CAUTI in the ICU, from 7.6 per 1,000 catheter-days (95% confidence interval [CI], 6.6-8.6) before the intervention to 5.0 per 1,000 catheter-days (95% CI, 4.2-5.8; P < .001) after the intervention. There also was a statistically significant reduction in the rate of CAUTI in the SDUs, from 15.3 per 1,000 catheter-days (95% CI, 13.9-16.6) before the intervention to 12.9 per 1,000 catheter-days (95% CI, 11.6-14.2) after the intervention (P = .014).ConclusionOur findings suggest that reducing CAUTI rates in the ICU setting is a complex process that involves multiple performance measures and interventions that can be applied to SDU settings as well.Copyright © 2011 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

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