[CSF07] Does catheter-associated urinary tract infection increase mortality in critically ill patients?

Revue Internationale avec comité de lecture : Journal Infection Control and Hospital epidemiology, vol. 28(12), pp. 21, 2007
Résumé: OBJECTIVE. To yield an accurate estimation of the association of catheter-associated urinary tract infection (CAUTI) with intensive care unit and hospital mortality, controlling for major confounding factors. DESIGN. Nested case-control study in a multi-center cohort (the OUTCOMEREA database). SETTING. Twelve French medical or surgical intensive care units. PATIENTS. All patients admitted between January 1997 and August 2005 requiring the insertion of an indwelling urinary catheter. Patients who developed CAUTI (cases) were matched to controls according to the following criteria: sex, age ± 10 years, SAPS (Simplified Acute Physiology Score) II score ± 10 points, length of urinary tract catheterization, and presence or absence of diabetes mellitus. The association of CAUTI with ICU and hospital mortality was assessed using conditional logistic regression. RESULTS. Of the 3281 patients with an indwelling urinary catheter, 298 (9 %) developed at least one episode of CAUTI. The incidence density of CAUTI was 12.9 per 1000 catheterization days. Crude ICU and hospital mortality rates were higher in patients with than in those without CAUTI (32% vs 25%, p = 0.02, and 43% vs 30%, p < 0.01, respectively). After matching and adjustment, CAUTI was no longer associated with increased mortality (ICU mortality: odds ratio -OR-: 0.846, 95% confidence interval -CI-: 0.659-1.086, p = 0.19; hospital mortality: OR: 0.949, 95% CI: 0.763-1.181, p = 0.64). CONCLUSION. After careful controlling for confounding factors, CAUTI was not associated with an excess in either ICU or hospital mortality in our population of critically ill patients.

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@article {
title="{Does catheter-associated urinary tract infection increase mortality in critically ill patients?}",
author="C. Clech and C. Schwebel and A. Franais and D. Toledano and J. Fosse and M. Garrouste-Orgeas and E. Azoulay and C. Adrie and S. Jamali and A. Descorps-Declere and D. Nakache and J. Timsit and Y. Cohen",
journal="Infection Control and Hospital epidemiology",