Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2006 Oct 12:6:15.
doi: 10.1186/1471-2318-6-15.

The association between indwelling urinary catheter use in the elderly and urinary tract infection in acute care

Susan E Hazelett  1 , Margaret Tsai, Michele Gareri, Kyle Allen
Affiliations

The association between indwelling urinary catheter use in the elderly and urinary tract infection in acute care

Susan E Hazelett et al. BMC Geriatr. .

Abstract

Background: The use of indwelling urinary catheters (IUCs) is thought to be the most significant risk factor for developing nosocomial urinary tract infections (UTIs). However, it is unclear how many elderly patients have preexisting bacteriuria prior to IUC placement. The purpose of this study was to determine 1) the frequency and appropriateness of IUC use in the Emergency Department (ED) in elderly patients admitted to our acute care hospital, 2) the percentage of elderly patients with an IUC who were discharged from the hospital with a diagnosis of UTI, 3) the percentage of patients with IUCs who were diagnosed and treated for UTI in the ED or who had admission bacteriuria > or =105 organisms/ml indicating preexisting UTI, and 4) the percentage of patients with no indication of UTI on admission who had inappropriately placed IUCs and subsequently were diagnosed with a UTI.

Methods: Retrospective chart review. Chi square used to test significance of differences in proportions.

Results: Seventy three percent of patients who received an IUC in the ED were elderly (> or =65 years old). During the study period, 277 elderly patients received an IUC prior to admission. Of these, 77 (28%) were diagnosed with UTI during their hospitalization. Fifty three (69%) of those diagnosed with a UTI by discharge either had the UTI diagnosed in the ED or had bacteriuria > or =105 organisms/ml prior to IUC placement. Of the 24 elderly patients who developed a catheter-associated UTI (i.e., 9% of the elderly population who received an IUC), 11 of the IUCs were placed inappropriately. Thus, 4% of elderly patients with no indication of UTI on admission who received an inappropriate IUC in the ED had a primary or secondary diagnosis of UTI by discharge. The overall rate of nosocomial UTI due to an inappropriately placed IUC was the same in males and females.

Conclusion: This study indicates that the strong association between IUC use and UTI may be partly explained by the high prevalence of preexisting UTI prior to IUC placement. Further prospective studies are needed to clarify the true risk vs benefit ratio for IUC use in acutely ill elderly patients.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Association between IUC use and UTI in an acutely ill elderly population.
Figure 2
Figure 2
Gender differences in IUC outcomes.
See this image and copyright information in PMC

References

    1. Wong ES. Guideline for prevention of catheter-associated urinary tract infections. CDC. http://www.cdc.gov/ncidod/dhqp/gl_catheter_assoc.html - PubMed
    1. Gokula RR, Hickner JA, Smith MA. Inappropriate use of urinary catheters in elderly patients at a Midwestern community teaching hospital. American Journal of Infection Control. 2004;32:196–99. doi: 10.1016/j.ajic.2003.08.007. - DOI - PubMed
    1. Nickel JC. Catheter-associated urinary tract infection:new perspectives on problems. Canadian Journal of Infect Control. 1991;6:38–42. - PubMed
    1. Stamm WE. Scientific and clinical challenges in the management of urinary tract infections. The American Journal of Medicine. 2002;113:1s–4s. doi: 10.1016/S0002-9343(02)01053-7. - DOI - PubMed
    1. Gardam MA, Amihod B, Orenstein P, Consolacion N, Miller M. Overutilization of indwelling urinary catheters and the development of nosocomial urinary tract infections. Clinical Performance and Quality Health Care. 1998;6:99–102. - PubMed

Publication types