title: Reducing urinary tract infections in colon and rectal surgery.
abstract: BACKGROUND
  Urinary tract infection is associated with increased morbidity, mortality, and healthcare costs. Colon and rectal surgery has been shown to be an independent risk factor for urinary tract infection. Decreased length of the indwelling urinary catheter may play a role in decreasing the rate of urinary tract infection.
  
  
  OBJECTIVE
  The aim of this study was to investigate the effect of standardized indwelling urinary catheter management on urinary tract infection.
  
  
  METHODS
  This was a prospective cohort study.
  
  
  METHODS
  This study was conducted in an urban academic tertiary care center.
  
  
  METHODS
  All of the patients were undergoing colon or rectal resection from 2010 to 2012 at a single National Surgical Quality Improvement Program participating institution.
  
  
  METHODS
  Intervention 1 (group 1) included implementation of a daily electronic order prompt requiring justification for an indwelling urinary catheter for >24 hours. Intervention 2 (group 2) included intervention 1 plus sterile intraoperative placement of a urinary catheter after the antiseptic preparation and draping of the patient.
  
  
  METHODS
  The primary outcome measured was urinary tract infection rate.
  
  
  RESULTS
  A total of 811 patients were identified (control = 215; group 1 = 476; group 2 = 120). Patient demographics and comorbidities were similar among the groups. No differences existed in the proportion of proctectomy among the groups. Urinary tract infection rate decreased significantly with the implementation of each intervention (control, 6.9%; group 1, 2.7%; group 2, 0.8%; p = 0.004). The lone urinary tract infection in group 2 involved ureteral reconstruction and stent placement at the time of surgery.
  
  
  CONCLUSIONS
  This study was limited by its small sample size and single institution design.
  
  
  CONCLUSIONS
  The implementation of 2 low-cost practice interventions was associated with a statistically significant decrease in urinary tract infection in patients undergoing colorectal surgery at an academic tertiary care center.
authors: Division of Colon and Rectal Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
authors: Deborah
authors: D
authors: Nagle
authors: Thomas
authors: T
authors: Curran
authors: Lorenzo
authors: L
authors: Anez-Bustillos
authors: Lorenzo
authors: L
authors: Anez-Bustillo
authors: Vitaliy
authors: V
authors: Poylin
mesh_terms: D000328:Adult; D000368:Aged; D055499:Catheter-Related Infections / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D015331:Cohort Studies; D003082:Colectomy; D003428:Cross Infection / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control*; D011446:Prospective Studies; D012007:Rectum / Q000601:surgery*; D016896:Treatment Outcome; D014546:Urinary Catheterization / Q000009:adverse effects / Q000379:methods*; D014552:Urinary Tract Infections / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*