Catheter-associated urinary tract infection is rarely symptomatic: a prospective study of 1,497 catheterized patients - PubMed (original) (raw)
Catheter-associated urinary tract infection is rarely symptomatic: a prospective study of 1,497 catheterized patients
P A Tambyah et al. Arch Intern Med. 2000.
Abstract
Background: Catheter-associated urinary tract infection (CAUTI) is the most common nosocomial infection, accounting for more than 1 million cases each year in US hospitals and nursing homes.
Objective: To define the clinical features of CAUTI.
Setting and patients: A university hospital; 1,497 newly catheterized patients.
Design: Every day that the catheter was in place, a quantitative urine culture and urine leukocyte count were obtained, and the patient was queried by a research worker regarding symptoms. To more precisely define the role of CAUTI in patients' symptoms, a subset of 1,034 patients, 89 of whom developed CAUTI with more than 10(3) colony-forming units per milliliter, who did not have another potentially confounding site of infection besides the urinary tract, was analyzed.
Outcome measures: Presence of fever, symptoms commonly associated with community-acquired urinary tract infection, and peripheral leukocytosis.
Results: There were 235 new cases of nosocomial CAUTI during the study period. More than 90% of the infected patients were asymptomatic; only 123 infections (52%) were detected by patients' physicians using the hospital laboratory. In the subset analysis, there were no significant differences between patients with and without CAUTI in signs or symptoms commonly associated with urinary tract infection-fever, dysuria, urgency, or flank pain-or in leukocytosis. Only 1 of the 235 episodes of CAUTI that were prospectively studied was unequivocally associated with secondary bloodstream infection.
Conclusions: Whereas CAUTIs are a major reservoir of antibiotic-resistant organisms in the hospital, they are rarely symptomatic and infrequently cause bloodstream infection. Symptoms referable to the urinary tract, fever, or peripheral leukocytosis have little predictive value for the diagnosis of CAUTI.
Similar articles
- The relationship between pyuria and infection in patients with indwelling urinary catheters: a prospective study of 761 patients.
Tambyah PA, Maki DG. Tambyah PA, et al. Arch Intern Med. 2000 Mar 13;160(5):673-7. doi: 10.1001/archinte.160.5.673. Arch Intern Med. 2000. PMID: 10724053 - The direct costs of nosocomial catheter-associated urinary tract infection in the era of managed care.
Tambyah PA, Knasinski V, Maki DG. Tambyah PA, et al. Infect Control Hosp Epidemiol. 2002 Jan;23(1):27-31. doi: 10.1086/501964. Infect Control Hosp Epidemiol. 2002. PMID: 11868889 - Catheter-associated urinary tract infection.
Danchaivijitr S, Dhiraputra C, Cherdrungsi R, Jintanothaitavorn D, Srihapol N. Danchaivijitr S, et al. J Med Assoc Thai. 2005 Dec;88 Suppl 10:S26-30. J Med Assoc Thai. 2005. PMID: 16850636 - Urinary tract infections in surgical patients.
Ramanathan R, Duane TM. Ramanathan R, et al. Surg Clin North Am. 2014 Dec;94(6):1351-68. doi: 10.1016/j.suc.2014.08.007. Epub 2014 Oct 3. Surg Clin North Am. 2014. PMID: 25440128 Review. - Catheter-associated urinary tract infections: new aspects of novel urinary catheters.
Ha US, Cho YH. Ha US, et al. Int J Antimicrob Agents. 2006 Dec;28(6):485-90. doi: 10.1016/j.ijantimicag.2006.08.020. Epub 2006 Oct 12. Int J Antimicrob Agents. 2006. PMID: 17045784 Review.
Cited by
- Best practice in primary care pathology: review 2.
Smellie WS, Forth JO, McNulty CA, Hirschowitz L, Lilic D, Gosling R, Bareford D, Logan E, Kerr KG, Spickett GP, Hoffman J, Galloway A, Bloxham CA. Smellie WS, et al. J Clin Pathol. 2006 Feb;59(2):113-20. doi: 10.1136/jcp.2005.031526. J Clin Pathol. 2006. PMID: 16443724 Free PMC article. Review. - Engineering out the risk for infection with urinary catheters.
Maki DG, Tambyah PA. Maki DG, et al. Emerg Infect Dis. 2001 Mar-Apr;7(2):342-7. doi: 10.3201/eid0702.010240. Emerg Infect Dis. 2001. PMID: 11294737 Free PMC article. Review. - Catheter-related urinary tract infection.
Nicolle LE. Nicolle LE. Drugs Aging. 2005;22(8):627-39. doi: 10.2165/00002512-200522080-00001. Drugs Aging. 2005. PMID: 16060714 Review. - Noninvasive ventilation for patients near the end of life: what do we know and what do we need to know?
Ehlenbach WJ, Curtis JR. Ehlenbach WJ, et al. Crit Care Med. 2008 Mar;36(3):1003-4. doi: 10.1097/CCM.0B013E318165FD78. Crit Care Med. 2008. PMID: 18431302 Free PMC article. No abstract available. - Positive urine cultures: A major cause of inappropriate antimicrobial use in hospitals?
Silver SA, Baillie L, Simor AE. Silver SA, et al. Can J Infect Dis Med Microbiol. 2009 Winter;20(4):107-11. doi: 10.1155/2009/702545. Can J Infect Dis Med Microbiol. 2009. PMID: 21119801 Free PMC article.
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Medical