Study: Urinary Catheters Are Leading Cause of Hospital-Acquired Infections

According to a new study published in the January issue of the journal Clinical Infectious Deseases, one in four hospitalized Americans has a urinary catheter. One percent of them will get a urinary tract infection from that catheter. All will require antibiotics, and a few may suffer life-threatening complications.

The study, which was conducted by a team of patient safety experts from the University of Michigan Health System and the VA Ann Arbor Healthcare System, says that UTIs are responsible for 40 percent of infections related to hospitalization. But despite this fact, American hospitals don't seem to have a consistent strategy for preventing catheter-related UTIs. In fact, the study shows, most hospitals aren't using basic tactics that have been proven to keep patients from getting catheter-related UTIs in the first place. Nearly one-third of hospitals didn't even track the UTI rates in their patient populations.

"Until now, we haven't had national data to tell us what hospitals are doing to prevent this common and costly patient-safety problem," said lead author Sanjay Saint, M.D., MPH, the director of the U-M/VA Patient Safety Enhancement Program. "Now that we have these data, it's clear that there's no one dominant practice that's being used, including physician reminders, which have proven benefit and make a lot of common sense."

The researchers designed a survey that they sent to all 119 VA hospitals in the Unites States, and to a random sample of 600 non-federal hospitals that have an intensive care unit and 50 or more hospital beds. This sample was designed to represent the 2,671 hospitals of that type in the U.S.

The survey asked about a range of practices that can be used to prevent hospital-acquired UTIs, including the use of catheters coated with antimicrobial agents that inhibit bacterial growth, the use of condom-style and suprapubic catheters that reduce the risk of bacteria entering the urethra, the use of antimicrobial agents in the drainage bags that collect urine, and the use of portable ultrasound bladder scanners to see of patients' bladders were truly being emptied without a catheter.

In all, the researchers found that less than a third of hospitals used either of the two most common tactics: bladder scanners and antimicrobial catheters. VA hospitals were more likely than non-VA hospitals to use bladder scanners, condom catheters and suprapubic catheters, but less likely to use the antimicrobial catheters, which cost about $5 more apiece than regular catheters.

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