Risk factors for healthcare-acquired urinary tract infections caused by multi-drug resistant microorganisms

Abstract

Introduction. Healthcare-acquired urinary tract infections (HAUTI) make up to 40% of all healthcareacquired infections and contribute significantly to hospital morbidity, mortality, and overall cost of treatment. Objective. The aim of our study was to investigate possible risk factors for development of HAUTI caused by multi-drug resistant pathogens. Methods. The prospective case-control study in a large tertiary-care hospital was conducted during a five-year period. The cases were patients with HAUTI caused by multi-drug resistant (MDR) pathogens, and the controls were patients with HAUTI caused by non-MDR pathogens. Results. There were 562 (62.6%) patients with MDR isolates and 336 (37.4%) patients with non-MDR isolates in the study. There were four significant predictors of HAUTI caused by MDR pathogens: hospitalization before insertion of urinary catheter for more than eight days (ORadjusted = 2.763; 95% CI = 1.352-5.647; p = 0.005), hospitalization for more than 15 days (ORadjusted = 2.144; 95% CI = 1.547-2.970; p < 0.001), previous stay in another department (intensive care units, other wards or hospitals) (ORadjusted = 2.147; 95% CI = 1.585-2.908; p < 0.001), and cancer of various localizations (ORadjusted = 2.313; 95% CI = 1.255-4.262; p = 0.007). Conclusion. Early removal of urinary catheter and reduction of time spent in a hospital or in an ICU could contribute to a decrease in the rate of HAUTI caused by MDR pathogens.

Keywords

• urinary tract infections
• nosocomial infections
• multiple antibacterial drug resistance
• risk factors