Huang Huiping, Huang Lei, Yan Sihan, Wang Chuanpeng, Wu Tingting, Chen Deqin, Chen Tingting, Chen Hongbing, Huang Weimin, Xue Alin, Yang Jianzhou, Chen Houzhi, Zhuang Guihua
School of Public Health, Health Science Center, Xi'an Jiaotong University, 76 West Yanta Road, Xi'an, 710061, China.
Department of Infection Control, the First Affiliated Hospital of Xiamen University, 55 Zhenhai Road, Xiamen, 361003, China.
BMC Infect Dis. 2025 Feb 21;25(1):248. doi: 10.1186/s12879-025-10638-7.
Catheter-associated urinary tract infections (CAUTIs) are one of the most common types of healthcare-associated infections (HAIs). Current studies mainly focus on risk factors, but the method to control them is unresolved. We aim to give an overview of the epidemiology of CAUTIs and explore the effects of bundle intervention on intensive care unit (ICU) inpatients.
A multi-center, double-blind, retrospective study was conducted in eight Xiamen medical centers over six months; we recruited ICU inpatients with indwelling urinary catheters (UC) > = 48 h. Data were analyzed using Chi-Square and student's t-test.
With bundle interventions, the CAUTI rate in ICUs decreased from 3.84 to 1.31 per 1000 UC days. The UC utilization was significantly reduced after bundles (71.29-62.70%), and the average duration of indwelling UC was reduced considerably (7,035 days vs. 6,884 days). CAUTIs in patients over 60 years old were significantly reduced after bundles. There were 45 causative organisms detected from 36 cases of CAUTIs, including 12 multidrug-resistant bacteria.
Bundles have been shown to reduce the risk of CAUTIs in patients with indwelling catheters in the ICU, especially older adults. It also significantly reduces the use of Carbapenem. Therefore, CAUTI bundles are recommended to clinicians.
导尿管相关尿路感染（CAUTIs）是医疗保健相关感染（HAIs）中最常见的类型之一。目前的研究主要集中在危险因素上，但控制这些因素的方法尚未解决。我们旨在概述CAUTIs的流行病学，并探讨集束干预对重症监护病房（ICU）住院患者的影响。
在厦门的八个医疗中心进行了一项为期六个月的多中心、双盲、回顾性研究；我们招募了留置导尿管（UC）≥48小时的ICU住院患者。使用卡方检验和学生t检验分析数据。
通过集束干预，ICU中每1000个导尿管日的CAUTI率从3.84降至1.31。集束干预后导尿管使用率显著降低（71.29% - 62.70%），留置导尿管的平均时间也大幅缩短（7035天对6884天）。60岁以上患者的CAUTIs在集束干预后显著减少。从36例CAUTIs病例中检测到45种病原体，其中包括12种多重耐药菌。
集束干预已被证明可降低ICU中留置导尿管患者，尤其是老年人发生CAUTIs的风险。它还显著减少了碳青霉烯类药物的使用。因此，建议临床医生采用CAUTI集束干预措施。
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