title: Trends in catheter-associated urinary tract infections in adult intensive care units-United States, 1990-2007.
abstract: BACKGROUND
  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.
  
  
  OBJECTIVE
  To examine changes in rates of CAUTI events in adult intensive care units (ICUs) in the United States from 1990 through 2007.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
authors.forename: Deron C
authors.initials: DC
authors.lastname: Burton
authors.forename: Jonathan R
authors.initials: JR
authors.lastname: Edwards
authors.forename: Arjun
authors.initials: A
authors.lastname: Srinivasan
authors.forename: Scott K
authors.initials: SK
authors.lastname: Fridkin
authors.forename: Carolyn V
authors.initials: CV
authors.lastname: Gould
mesh_terms: D000328:Adult; D055499:Catheter-Related Infections / Q000453:epidemiology* / Q000382:microbiology; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D016012:Poisson Distribution; D011159:Population Surveillance; D012044:Regression Analysis; D014481:United States / Q000453:epidemiology; D014552:Urinary Tract Infections / Q000453:epidemiology* / Q000382:microbiology