Tuesday, November 26, 2013

Bacteremia and Mortality from a Urinary Catheter

I am back from Argentina and back to work.

Here is an investigation on bacteremia and mortality associated with urinary catheters.
The author's focused on catheter-associated urinary tract infection (CAUTI) and catheter-associated asymptomatic bacteriuria (CAABU)  and studied the relationship between catheter-associated bacteriuria and bacteremia from a urinary source in CAUTI relative to that in CAABU.

There were 444 episodes of catheter-associated bacteriuria in 308 patients; 128 (41.6%) patients had CAUTI, and 180 (58.4%) had CAABU. Three episodes of bacteriuria were followed by bacteremia from a urinary source (0.7%). CAUTI, rather than CAABU, was associated with bacteremia from any source, but neither CAUTI nor CAABU predicted subsequent mortality.

Bacteremia from a urinary source was an infrequent event. In addition, there was no evidence of an association of mortality with symptomatic versus asymptomatic bacteriuria.  

Catheter associated urinary tract infections are the most common hospital acquired infection yet result in the least morbidity and mortality. This does not negate their relevance, however, in terms of truly impacting patient safety, the most bang for the buck is in the prevention of bloodstream infections and ventilator associated pneumonia.