title: Trends in catheter-associated urinary tract infections among a national cohort of hospitalized adults, 2001-2010.
abstract: BACKGROUND
  Catheter-associated urinary tract infections (CAUTIs) have become a major public health concern in the United States. This study provides national estimates of CAUTI incidence, mortality, and associated hospital length of stay (LOS) over a 10-year period.
  
  
  METHODS
  This was a retrospective analysis of the National Hospital Discharge Surveys from 2001 to 2010. Adults age ≥18 years with an International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) procedure code for urinary catheter placement or other major procedure were included. Urinary tract infections were identified by ICD-9-CM code. Data weights were applied to derive national estimates. Predictors of CAUTI were identified using a logistic regression model.
  
  
  RESULTS
  These data represent 70.4 million catheterized patients, 3.8 million of whom developed a CAUTI. The incidence of CAUTIs decreased from 9.4 cases/100 catheterizations in 2001 to 5.3 cases/100 catheterizations in 2010. Mortality in patients with a CAUTI declined from 5.4% in 2001 to 3.7% in 2010. Median (interquartile range [IQR]) hospital LOS also declined, from 9 days (IQR, 5-16 days) in 2001 to 7 days (IQR, 4-12 days) in 2010. Independent predictors of CAUTI included female sex, emergency hospital admission, transfer from another facility, and Medicaid payment (P < .0001 for all variables).
  
  
  CONCLUSIONS
  The incidence of CAUTIs in US hospitals declined over the study period. Furthermore, patients with these infections experienced lower hospital mortality and shorter hospital LOS.
authors.affiliation: College of Pharmacy, University of Texas at Austin, Austin, TX; Pharmacotherapy Education and Research Center, University of Texas Health Science Center at San Antonio, San Antonio, TX.
authors.forename: Kelly R
authors.initials: KR
authors.lastname: Daniels
authors.affiliation: College of Pharmacy, University of Texas at Austin, Austin, TX; Pharmacotherapy Education and Research Center, University of Texas Health Science Center at San Antonio, San Antonio, TX.
authors.forename: Grace C
authors.initials: GC
authors.lastname: Lee
authors.affiliation: College of Pharmacy, University of Texas at Austin, Austin, TX; Pharmacotherapy Education and Research Center, University of Texas Health Science Center at San Antonio, San Antonio, TX. Electronic address: freic@uthscsa.edu.
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Frei
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D055499:Catheter-Related Infections / Q000453:epidemiology* / Q000401:mortality; D003428:Cross Infection / Q000453:epidemiology* / Q000401:mortality; D005260:Female; D006801:Humans; D015994:Incidence; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016019:Survival Analysis; D014481:United States / Q000453:epidemiology; D014552:Urinary Tract Infections / Q000453:epidemiology* / Q000401:mortality
keywords: Health care epidemiology; Health care-associated infections; Medical device infections; Population health