Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
Infect Control Hosp Epidemiol. 2011 Aug;32(8):748-56. doi: 10.1086/660872.
Over the past 2 decades, multiple interventions have been developed to prevent catheter-associated urinary tract infections (CAUTIs). The CAUTI prevention guidelines of the Healthcare Infection Control Practices Advisory Committee were recently revised.
To examine changes in rates of CAUTI events in adult intensive care units (ICUs) in the United States from 1990 through 2007.
Data were reported to the Centers for Disease Control and Prevention (CDC) through the National Nosocomial Infections Surveillance System from 1990 through 2004 and the National Healthcare Safety Network from 2006 through 2007. Infection preventionists in participating hospitals used standard methods to identify all CAUTI events (categorized as symptomatic urinary tract infection [SUTI] or asymptomatic bacteriuria [ASB]) and urinary catheter-days (UC-days) in months selected for surveillance. Data from all facilities were aggregated to calculate pooled mean annual SUTI and ASB rates (in events per 1,000 UC-days) by ICU type. Poisson regression was used to estimate percent changes in rates over time.
Overall, 36,282 SUTIs and 22,973 ASB episodes were reported from 367 facilities representing 1,223 adult ICUs, including combined medical/surgical (505), medical (212), surgical (224), coronary (173), and cardiothoracic (109) ICUs. All ICU types experienced significant declines of 19%-67% in SUTI rates and 29%-72% in ASB rates from 1990 through 2007. Between 2000 and 2007, significant reductions in SUTI rates occurred in all ICU types except cardiothoracic ICUs.
Since 1990, CAUTI rates have declined significantly in all major adult ICU types in facilities reporting to the CDC. Further efforts are needed to assess prevention strategies that might have led to these decreases and to implement new CAUTI prevention guidelines.
在过去的 20 年中，已经开发出多种干预措施来预防导管相关尿路感染（CAUTI）。医疗保健感染控制实践咨询委员会的 CAUTI 预防指南最近进行了修订。
检查 1990 年至 2007 年期间美国成人重症监护病房（ICU）中 CAUTI 事件的发生率变化。
通过国家医院感染监测系统（1990 年至 2004 年）和国家医疗保健安全网络（2006 年至 2007 年）向疾病预防控制中心（CDC）报告数据。参与医院的感染预防人员使用标准方法来确定所有 CAUTI 事件（分类为有症状尿路感染[SUTI]或无症状菌尿[ASB]）和在选定的监测月份中的尿导管天数（UC-天）。将所有设施的数据汇总在一起，以计算按 ICU 类型分类的 pooled mean annual SUTI 和 ASB 发生率（每 1000 UC-天的事件数）。使用泊松回归估计随时间变化的发生率的百分比变化。
总体而言，来自 367 家代表 1223 家成人 ICU 的设施的 367 家设施报告了 36282 例 SUTI 和 22973 例 ASB 发作，包括综合内科/外科（505）、内科（212）、外科（224）、冠心病（173）和心胸外科（109） ICU。从 1990 年到 2007 年，所有 ICU 类型的 SUTI 发生率均下降了 19％至 67％，ASB 发生率下降了 29％至 72％。2000 年至 2007 年期间，除心胸外科 ICU 外，所有 ICU 类型的 SUTI 发生率均显著下降。
自 1990 年以来，报告给 CDC 的所有主要成人 ICU 类型的 CAUTI 发生率均显著下降。需要进一步努力评估可能导致这些下降的预防策略，并实施新的 CAUTI 预防指南。
