Risk factors of nosocomial catheter-associated urinary tract infection in a polyvalent intensive care unit

Objective. To determine the risk factors for catheter-associated urinary tract infection in a polyvalent intensive care unit (ICU). Design. Prospective cohort study. Setting. Sixteen-bed polyvalent ICU in a French university hospital. Interventions. Prospective patient surveillance of patients included in two successive studies of two urine drainage systems. Main outcome measures. Bacteriuria occurrence in 553 ICU patients requiring a bladder catheter for longer than 48 h. The following variables were analyzed as possible risk factors: age, sex, severity score at admission, diagnosis on admission, duration of bladder catheterization, length of ICU stay, prior exposure to antibiotics, and system of urine drainage. Results. The frequency of catheter-associated bacteriuria was 9.6%. From the multivariate analysis, five independent risk factors were determined: female sex, length of ICU stay, use of an antimicrobial therapy, severity score at admission, and duration of catheterization. Conclusion. In our study, the drainage system did not influence the occurrence of bacteriuria. To decrease the rate of catheter-associated bacteriuria in polyvalent ICU patients, removal of the bladder catheter must be performed as soon as possible.