Department of Preventive Medicine and Community Health, School of Medicine, University of Occupational and Environmental Health.
Data Science Center of Occupational Health, University of Occupational and Environmental Health.
J Epidemiol. 2018 Jan 5;28(1):54-58. doi: 10.2188/jea.JE20170022. Epub 2017 Oct 25.
Catheter-associated urinary tract infection (CAUTI) is a common nosocomial infection. However, the effectiveness of antimicrobial catheters in reducing CAUTI in cerebral infarction patients is unknown. The purpose of this study was to determine whether antimicrobial catheters protect against CAUTI in cerebral infarction patients.
We identified 27,548 patients from the Japanese Diagnosis Procedure Combination Database who had been admitted from April 1, 2012 through March 31, 2014 for acute management of cerebral infarction and had used at least an indwelling urethral catheter. We extracted data on patient sex, age, comorbidity, length of stay, activities of daily living (ADL), surgery, hospital case volume, and catheter type. We defined CAUTI as a urinary tract infection arising during admission. We performed multi-level logistic regression analysis to analyze the reduction in CAUTI using antimicrobial catheters.
The rate of CAUTI was 8.8% and 8.3% in the control and antimicrobial catheter groups, respectively. Significant risk factors for CAUTI were age, diabetes requiring insulin therapy, low ADL score, and long hospitalization. Incidence rate was significantly lower in operated cases and those treated with tissue plasminogen activator. For all cases overall, the use of an antimicrobial catheter was not associated with a lower CAUTI rate. However, use was associated with a lower rate of CAUTI in diabetic patients on insulin.
Antimicrobial catheter use was not associated with a lower incidence rate of CAUTI in acute cerebral infarction patients. However, stratified analysis suggested that use was associated with a lower incidence in diabetic patients on insulin.
导管相关尿路感染（CAUTI）是一种常见的医院获得性感染。然而，抗菌导管在降低脑梗死患者 CAUTI 方面的效果尚不清楚。本研究旨在确定抗菌导管是否能预防脑梗死患者发生 CAUTI。
我们从日本诊断程序组合数据库中确定了 27548 名患者，这些患者于 2012 年 4 月 1 日至 2014 年 3 月 31 日因急性脑梗死入院，至少使用了留置导尿管。我们提取了患者性别、年龄、合并症、住院时间、日常生活活动（ADL）、手术、医院病例量和导管类型的数据。我们将 CAUTI 定义为住院期间发生的尿路感染。我们使用多水平逻辑回归分析来分析抗菌导管在降低 CAUTI 方面的效果。
对照组和抗菌导管组的 CAUTI 发生率分别为 8.8%和 8.3%。CAUTI 的显著危险因素是年龄、需要胰岛素治疗的糖尿病、ADL 评分低和住院时间长。手术和使用组织型纤溶酶原激活剂治疗的患者发生率较低。对于所有病例，抗菌导管的使用与较低的 CAUTI 发生率无关。然而，在使用胰岛素的糖尿病患者中，抗菌导管的使用与较低的 CAUTI 发生率相关。
抗菌导管的使用与急性脑梗死患者 CAUTI 的发生率降低无关。然而，分层分析表明，在使用胰岛素的糖尿病患者中，抗菌导管的使用与较低的 CAUTI 发生率相关。
