J Korean Med Sci.  2024 May;39(18):e151. 10.3346/jkms.2024.39.e151.

Impact of Infection Prevention Programs on Catheter-Associated Urinary Tract Infections Analyzed in Multicenter Study

• Na SH
• Eom JS
• Seo YB
• Park SH
• Kim YK
• Song W
• Lee E
• Kim SR
• Yoo HM
• Chun H
• Shin MJ
• Kim SH
• Choi JY
• Cho Nh
• Kim JH
• Son Hj
• Han Sh
• Lee J

• KMID: 2555501
• DOI: http://doi.org/10.3346/jkms.2024.39.e151

Abstract

Background
Catheter-associated urinary tract infections (CAUTIs) account for a large proportion of healthcare-associated infections and have a significant impact on morbidity, length of hospital stay, and mortality. Adherence to the recommended infection prevention practices can effectively reduce the incidence of CAUTIs. This study aimed to assess the characteristics of CAUTIs and the efficacy of prevention programs across hospitals of various sizes.
Methods
Intervention programs, including training, surveillance, and monitoring, were implemented. Data on the microorganisms responsible for CAUTIs, urinary catheter utilization ratio, rate of CAUTIs per 1,000 device days, and factors associated with the use of indwelling catheters were collected from 2017 to 2019. The incidence of CAUTIs and associated data were compared between university hospitals and small- and medium-sized hospitals.
Results
Thirty-two hospitals participated in the study, including 21 university hospitals and 11 small- and medium-sized hospitals. The microorganisms responsible for CAUTIs and their resistance rates did not differ between the two groups. In the first quarter of 2018, the incidence rate was 2.05 infections/1,000 device-days in university hospitals and 1.44 infections/1,000 device-days in small- and medium-sized hospitals. After implementing interventions, the rate gradually decreased in the first quarter of 2019, with 1.18 infections/1,000 device-days in university hospitals and 0.79 infections/1,000 device-days in small- and medium-sized hospitals. However, by the end of the study, the infection rate increased to 1.74 infections/1,000 device-days in university hospitals and 1.80 infections/1,000 device-days in small- and medium-sized hospitals.
Conclusion
We implemented interventions to prevent CAUTIs and evaluated their outcomes. The incidence of these infections decreased in the initial phases of the intervention when adequate support and personnel were present. The rate of these infections may be reduced by implementing active interventions such as consistent monitoring and adherence to guidelines for preventing infections.

Keyword

Indwelling Catheters; Catheter-Associated Urinary Tract Infection; Intervention

Figure

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  Fig. 1 Timeline for programs to prevent catheter-associated urinary tract infections from 2017 to 2019.aHand washing, use sterile globe, use sterile drapes, disinfect skin, use disposable lubricant, monitoring for urinary catheter kinking, maintaining a closed system, fixation, use separate collection containers for each patient, regular assessment of urethral catheterization.bAssessment of the appropriateness of producing the checklist, evaluate the adequacy of monitoring methods, whether intervention activities had been carried out.

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