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1160. CAUTIs are the Most Common Type of Healthcare-Associated Infection. In an Effort to Decrease CAUTI Rates Through Proactive Prevention, We Sought to Develop a Weighted Model of CAUTI Risk Factors. The Final Set of Risk Factors Jointly Predicting CAUTI Were ADL Dependent, CVA, Catheter Replacement Within 7 days, and Catheterization Duration ≥5. We Have Defined Contemporary Weighted Risk Factors for CAUTI and Intend to Utilize These to Deploy a Tiered Approach Where Patients with Risk Factors Will Receive Advanced in Addition to Basic Preventive Efforts

BACKGROUND: Catheter-associated urinary tract infections (CAUTI) are the most common type of healthcare-associated infection. In an effort to decrease CAUTI rates through proactive prevention, we sought to develop a weighted model of CAUTI risk factors in our patient population. METHODS: A retrospec...

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Autores principales: Nanda, Neha, Aleksanyan, Meline
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6808995/
http://dx.doi.org/10.1093/ofid/ofz360.1023
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author Nanda, Neha
Aleksanyan, Meline
author_facet Nanda, Neha
Aleksanyan, Meline
author_sort Nanda, Neha
collection PubMed
description BACKGROUND: Catheter-associated urinary tract infections (CAUTI) are the most common type of healthcare-associated infection. In an effort to decrease CAUTI rates through proactive prevention, we sought to develop a weighted model of CAUTI risk factors in our patient population. METHODS: A retrospective case–control study was conducted to identify potential CAUTI risk factors in a 401-bed, acute care, tertiary academic facility. Data were collected through chart review of CAUTI cases between January 2014 and June 2018. Controls were catheterized patients who did not develop a CAUTI, and were selected based on the corresponding case event date (±7 days) and location. The case to control ratio was 1:2. A multivariable logistic regression was used to identify CAUTI risk factors by stepwise selection. All tests were 2-sided at a 0.05 significance level. All statistical analyses were performed using SAS 9.4. RESULTS: We reviewed 501 patients. The mean age was 62.7 years and 51% were female. The most common organisms in CAUTI cases (n = 167) were Escherichia coli (28.7%) and Pseudomonas aeruginosa (18.6%). Median catheterization duration for cases and controls was 8 and 5 days, respectively. Univariate logistic regression analyses revealed the following statistically significant risk factors: female, catheterization duration ≥5 days, ADL-dependent, cerebrovascular disease (CVA), nonoperating room procedure, catheter placement in operating room and history of malignancy. The final set of risk factors jointly predicting CAUTI included ADL-dependent (OR 1.69), CVA (OR 7.3), catheter replacement within 7 days (OR 1.85), and catheterization duration ≥5 (OR 2.1). The final model’s AUC was 0.72. Risk factors were scored using β coefficient from the final model. The highest score attainable was 20 with CVA receiving the maximum weight. The risk score’s ability to classify infection was measured by AUC of 0.60. CONCLUSION: In our study, we have defined contemporary weighted risk factors associated with CAUTI. We intend to utilize these findings to deploy a tiered approach where patients with risk factors will receive ‘advanced’ in addition to ‘basic’ preventive efforts. Additionally, our risk score model will allow for prioritizing efforts. DISCLOSURES: All authors: No reported disclosures.
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spelling pubmed-68089952019-10-28 1160. CAUTIs are the Most Common Type of Healthcare-Associated Infection. In an Effort to Decrease CAUTI Rates Through Proactive Prevention, We Sought to Develop a Weighted Model of CAUTI Risk Factors. The Final Set of Risk Factors Jointly Predicting CAUTI Were ADL Dependent, CVA, Catheter Replacement Within 7 days, and Catheterization Duration ≥5. We Have Defined Contemporary Weighted Risk Factors for CAUTI and Intend to Utilize These to Deploy a Tiered Approach Where Patients with Risk Factors Will Receive Advanced in Addition to Basic Preventive Efforts Nanda, Neha Aleksanyan, Meline Open Forum Infect Dis Abstracts BACKGROUND: Catheter-associated urinary tract infections (CAUTI) are the most common type of healthcare-associated infection. In an effort to decrease CAUTI rates through proactive prevention, we sought to develop a weighted model of CAUTI risk factors in our patient population. METHODS: A retrospective case–control study was conducted to identify potential CAUTI risk factors in a 401-bed, acute care, tertiary academic facility. Data were collected through chart review of CAUTI cases between January 2014 and June 2018. Controls were catheterized patients who did not develop a CAUTI, and were selected based on the corresponding case event date (±7 days) and location. The case to control ratio was 1:2. A multivariable logistic regression was used to identify CAUTI risk factors by stepwise selection. All tests were 2-sided at a 0.05 significance level. All statistical analyses were performed using SAS 9.4. RESULTS: We reviewed 501 patients. The mean age was 62.7 years and 51% were female. The most common organisms in CAUTI cases (n = 167) were Escherichia coli (28.7%) and Pseudomonas aeruginosa (18.6%). Median catheterization duration for cases and controls was 8 and 5 days, respectively. Univariate logistic regression analyses revealed the following statistically significant risk factors: female, catheterization duration ≥5 days, ADL-dependent, cerebrovascular disease (CVA), nonoperating room procedure, catheter placement in operating room and history of malignancy. The final set of risk factors jointly predicting CAUTI included ADL-dependent (OR 1.69), CVA (OR 7.3), catheter replacement within 7 days (OR 1.85), and catheterization duration ≥5 (OR 2.1). The final model’s AUC was 0.72. Risk factors were scored using β coefficient from the final model. The highest score attainable was 20 with CVA receiving the maximum weight. The risk score’s ability to classify infection was measured by AUC of 0.60. CONCLUSION: In our study, we have defined contemporary weighted risk factors associated with CAUTI. We intend to utilize these findings to deploy a tiered approach where patients with risk factors will receive ‘advanced’ in addition to ‘basic’ preventive efforts. Additionally, our risk score model will allow for prioritizing efforts. DISCLOSURES: All authors: No reported disclosures. Oxford University Press 2019-10-23 /pmc/articles/PMC6808995/ http://dx.doi.org/10.1093/ofid/ofz360.1023 Text en © The Author(s) 2019. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Abstracts
Nanda, Neha
Aleksanyan, Meline
1160. CAUTIs are the Most Common Type of Healthcare-Associated Infection. In an Effort to Decrease CAUTI Rates Through Proactive Prevention, We Sought to Develop a Weighted Model of CAUTI Risk Factors. The Final Set of Risk Factors Jointly Predicting CAUTI Were ADL Dependent, CVA, Catheter Replacement Within 7 days, and Catheterization Duration ≥5. We Have Defined Contemporary Weighted Risk Factors for CAUTI and Intend to Utilize These to Deploy a Tiered Approach Where Patients with Risk Factors Will Receive Advanced in Addition to Basic Preventive Efforts
title 1160. CAUTIs are the Most Common Type of Healthcare-Associated Infection. In an Effort to Decrease CAUTI Rates Through Proactive Prevention, We Sought to Develop a Weighted Model of CAUTI Risk Factors. The Final Set of Risk Factors Jointly Predicting CAUTI Were ADL Dependent, CVA, Catheter Replacement Within 7 days, and Catheterization Duration ≥5. We Have Defined Contemporary Weighted Risk Factors for CAUTI and Intend to Utilize These to Deploy a Tiered Approach Where Patients with Risk Factors Will Receive Advanced in Addition to Basic Preventive Efforts
title_full 1160. CAUTIs are the Most Common Type of Healthcare-Associated Infection. In an Effort to Decrease CAUTI Rates Through Proactive Prevention, We Sought to Develop a Weighted Model of CAUTI Risk Factors. The Final Set of Risk Factors Jointly Predicting CAUTI Were ADL Dependent, CVA, Catheter Replacement Within 7 days, and Catheterization Duration ≥5. We Have Defined Contemporary Weighted Risk Factors for CAUTI and Intend to Utilize These to Deploy a Tiered Approach Where Patients with Risk Factors Will Receive Advanced in Addition to Basic Preventive Efforts
title_fullStr 1160. CAUTIs are the Most Common Type of Healthcare-Associated Infection. In an Effort to Decrease CAUTI Rates Through Proactive Prevention, We Sought to Develop a Weighted Model of CAUTI Risk Factors. The Final Set of Risk Factors Jointly Predicting CAUTI Were ADL Dependent, CVA, Catheter Replacement Within 7 days, and Catheterization Duration ≥5. We Have Defined Contemporary Weighted Risk Factors for CAUTI and Intend to Utilize These to Deploy a Tiered Approach Where Patients with Risk Factors Will Receive Advanced in Addition to Basic Preventive Efforts
title_full_unstemmed 1160. CAUTIs are the Most Common Type of Healthcare-Associated Infection. In an Effort to Decrease CAUTI Rates Through Proactive Prevention, We Sought to Develop a Weighted Model of CAUTI Risk Factors. The Final Set of Risk Factors Jointly Predicting CAUTI Were ADL Dependent, CVA, Catheter Replacement Within 7 days, and Catheterization Duration ≥5. We Have Defined Contemporary Weighted Risk Factors for CAUTI and Intend to Utilize These to Deploy a Tiered Approach Where Patients with Risk Factors Will Receive Advanced in Addition to Basic Preventive Efforts
title_short 1160. CAUTIs are the Most Common Type of Healthcare-Associated Infection. In an Effort to Decrease CAUTI Rates Through Proactive Prevention, We Sought to Develop a Weighted Model of CAUTI Risk Factors. The Final Set of Risk Factors Jointly Predicting CAUTI Were ADL Dependent, CVA, Catheter Replacement Within 7 days, and Catheterization Duration ≥5. We Have Defined Contemporary Weighted Risk Factors for CAUTI and Intend to Utilize These to Deploy a Tiered Approach Where Patients with Risk Factors Will Receive Advanced in Addition to Basic Preventive Efforts
title_sort 1160. cautis are the most common type of healthcare-associated infection. in an effort to decrease cauti rates through proactive prevention, we sought to develop a weighted model of cauti risk factors. the final set of risk factors jointly predicting cauti were adl dependent, cva, catheter replacement within 7 days, and catheterization duration ≥5. we have defined contemporary weighted risk factors for cauti and intend to utilize these to deploy a tiered approach where patients with risk factors will receive advanced in addition to basic preventive efforts
topic Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6808995/
http://dx.doi.org/10.1093/ofid/ofz360.1023
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