Risk factors of nosocomial catheter-associated urinary tract infection in a polyvalent intensive care unit.

Objective: To determine the risk factors for catheter-associated urinary tract infection in a polyvalent intensive care unit (ICU).

Design And Setting: Prospective cohort study in a 16-bed polyvalent ICU in a French university hospital.

Interventions: Prospective patient surveillance of patients included in two successive studies of two urine drainage systems.

Measurements And Results: Bacteriuria occurrence in 553 ICU patients requiring a bladder catheter for longer than 48 h. The following variables were analyzed as possible risk factors: age, sex, severity score at admission, diagnosis on admission, duration of bladder catheterization, length of ICU stay, prior exposure to antibiotics, and system of urine drainage. The frequency of catheter-associated bacteriuria was 9.6%. From the multivariate analysis, five independent risk factors were determined: sex female, length of ICU stay, use of an antimicrobial therapy, severity score at admission, and duration of catheterization.

Conclusions: In our study the drainage system did not influence the occurrence of bacteriuria. To decrease the rate of catheter-associated bacteriuria in polyvalent ICU patients removal of the bladder catheter must be performed as soon as possible.