Nosocomial urinary tract infections in urologic patients: assessment of a prospective surveillance program including 10,000 patients.
OBJECTIVE
Hospital-acquired urinary tract infections (HUTI) represent a significant impairment in the quality of health care. Incidence in catheterized patients has been estimated at approximately 20%, however few data are available in urologic patients. We report a prospective surveillance program over 6 years in our urologic department and evaluate its evolution.


METHODS
Population consists of all patients admitted to the urology ward for 48 hours or more over a 6-year period from 1994. Data recorded: age, gender, duration of stay, insertion and removal of catheters, diagnosis of HUTI.


METHODS
calculation of incidence, and incidence density for HUTI and for catheter-related HUTI, analysis of trends by chi(2) trend test.


RESULTS
A total of 10,054 consecutive patients were included, 52% were catheterized. The median incidence of catheter-related HUTI in catheterized patients was 13.0%, the incidence density was 25.1 HUTI/1000 patient-days of catheterization. The proportion of HUTI and specific catheter-related HUTI patients decreased, respectively from 8.4% and 14.2% to 6.5% and 12.3% during the study period (p<0.05).


CONCLUSIONS
The rate of HUTI was not as high as previously reported, perhaps due to a controlled catheter policy. Surveillance was associated with a significant decrease in infection rates, suggesting a beneficial feedback effect. Evaluation of diagnoses and surgical procedures would ensure an optimal quality control program.
Merle
Veronique
V
Department of Epidemiology and Public Health, Rouen University Hospital Charles Nicolle, 1 Rue de Germont, 76031 Rouen, France.
Germain
Jeanne-Marie
JM
Bugel
Hubert
H
Nouvellon
Michèle
M
Lemeland
Jean-François
JF
Czernichow
Pierre
P
Grise
Philippe
P
D000328:Adult; D000368:Aged; D003428:Cross Infection / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D005602:France / Q000453:epidemiology; D006785:Hospitals, University; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D019984:Quality Indicators, Health Care / Q000706:statistics & numerical data; D012307:Risk Factors; D018571:Sentinel Surveillance; D014546:Urinary Catheterization / Q000009:adverse effects*; D014552:Urinary Tract Infections / Q000453:epidemiology* / Q000209:etiology; D014570:Urologic Diseases / Q000150:complications