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P29 Catheter-associated urinary tract infections, potential for diagnostic and antimicrobial stewardship

BACKGROUND AND OBJECTIVES: Catheter-associated urinary tract infections (CAUTIs) are one of the most common healthcare-associated infections.(1) Microbiological investigation of catheter specimens of urine (CSUs) results in a significant workload for microbiology laboratories. As bacteria cultured f...

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Autores principales: Kelly, Siobháin, O’ Donnell, Sinead, Powderly, Ailish, Fitzpatrick, Fidelma
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10395447/
http://dx.doi.org/10.1093/jacamr/dlad077.033
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author Kelly, Siobháin
O’ Donnell, Sinead
Powderly, Ailish
Fitzpatrick, Fidelma
author_facet Kelly, Siobháin
O’ Donnell, Sinead
Powderly, Ailish
Fitzpatrick, Fidelma
author_sort Kelly, Siobháin
collection PubMed
description BACKGROUND AND OBJECTIVES: Catheter-associated urinary tract infections (CAUTIs) are one of the most common healthcare-associated infections.(1) Microbiological investigation of catheter specimens of urine (CSUs) results in a significant workload for microbiology laboratories. As bacteria cultured from CSUs often reflect colonization rather than infection, we must prudently interpret these culture results and judiciously prescribe antimicrobials in this setting. For these reasons, we felt it was important to assess if CAUTIs are being appropriately investigated and managed in our hospital. METHODS: We identified all the CSUs received in the microbiology laboratory from inpatients over a 7 day period in an 820-bed adult tertiary referral hospital. Once identified, a retrospective review of each patient’s clinical and drug charts was undertaken. The CDC definition of CAUTI was applied for the purpose of this audit.(2) RESULTS: A total of 126 CSUs from 101 patients were included. The majority of patients (n=79, 78%) had a urinary catheter introduced during their hospital admission. At the time of CSU sampling, suspicion of infection was documented in only 47 patients. Only 9% of patients who had a CSU processed met the criteria for a CAUTI.(2) Fifty-six percent of patients were commenced on antibiotics, despite only 31% returning a culture positive CSU sample. CSU results were documented in only 10% of patient charts. In cases where a CAUTI was suspected, it took an average of 6.75 days for the urinary catheter to be exchanged or removed. Four patients continued to receive an antibiotic despite the organism isolated being reported as resistant. CONCLUSIONS: Overall, we noted that there was poor documentation of both urinary catheter status and of CSU results. Our audit revealed that several patients had multiple specimens processed within the 7 day period. Most patients had no clear indication for CSU sampling. From an antimicrobial stewardship perspective, there was unnecessary and inappropriate prescribing of antimicrobials. The results of this audit show that there is potential for both diagnostic and antimicrobial stewardship in the management of CAUTIs.
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spelling pubmed-103954472023-08-03 P29 Catheter-associated urinary tract infections, potential for diagnostic and antimicrobial stewardship Kelly, Siobháin O’ Donnell, Sinead Powderly, Ailish Fitzpatrick, Fidelma JAC Antimicrob Resist Abstracts BACKGROUND AND OBJECTIVES: Catheter-associated urinary tract infections (CAUTIs) are one of the most common healthcare-associated infections.(1) Microbiological investigation of catheter specimens of urine (CSUs) results in a significant workload for microbiology laboratories. As bacteria cultured from CSUs often reflect colonization rather than infection, we must prudently interpret these culture results and judiciously prescribe antimicrobials in this setting. For these reasons, we felt it was important to assess if CAUTIs are being appropriately investigated and managed in our hospital. METHODS: We identified all the CSUs received in the microbiology laboratory from inpatients over a 7 day period in an 820-bed adult tertiary referral hospital. Once identified, a retrospective review of each patient’s clinical and drug charts was undertaken. The CDC definition of CAUTI was applied for the purpose of this audit.(2) RESULTS: A total of 126 CSUs from 101 patients were included. The majority of patients (n=79, 78%) had a urinary catheter introduced during their hospital admission. At the time of CSU sampling, suspicion of infection was documented in only 47 patients. Only 9% of patients who had a CSU processed met the criteria for a CAUTI.(2) Fifty-six percent of patients were commenced on antibiotics, despite only 31% returning a culture positive CSU sample. CSU results were documented in only 10% of patient charts. In cases where a CAUTI was suspected, it took an average of 6.75 days for the urinary catheter to be exchanged or removed. Four patients continued to receive an antibiotic despite the organism isolated being reported as resistant. CONCLUSIONS: Overall, we noted that there was poor documentation of both urinary catheter status and of CSU results. Our audit revealed that several patients had multiple specimens processed within the 7 day period. Most patients had no clear indication for CSU sampling. From an antimicrobial stewardship perspective, there was unnecessary and inappropriate prescribing of antimicrobials. The results of this audit show that there is potential for both diagnostic and antimicrobial stewardship in the management of CAUTIs. Oxford University Press 2023-08-02 /pmc/articles/PMC10395447/ http://dx.doi.org/10.1093/jacamr/dlad077.033 Text en © The Author(s) 2023. Published by Oxford University Press on behalf of British Society for Antimicrobial Chemotherapy. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Abstracts
Kelly, Siobháin
O’ Donnell, Sinead
Powderly, Ailish
Fitzpatrick, Fidelma
P29 Catheter-associated urinary tract infections, potential for diagnostic and antimicrobial stewardship
title P29 Catheter-associated urinary tract infections, potential for diagnostic and antimicrobial stewardship
title_full P29 Catheter-associated urinary tract infections, potential for diagnostic and antimicrobial stewardship
title_fullStr P29 Catheter-associated urinary tract infections, potential for diagnostic and antimicrobial stewardship
title_full_unstemmed P29 Catheter-associated urinary tract infections, potential for diagnostic and antimicrobial stewardship
title_short P29 Catheter-associated urinary tract infections, potential for diagnostic and antimicrobial stewardship
title_sort p29 catheter-associated urinary tract infections, potential for diagnostic and antimicrobial stewardship
topic Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10395447/
http://dx.doi.org/10.1093/jacamr/dlad077.033
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