title: Comparison of Catheter-associated Urinary Tract Infection Rates by Perineal Care Agents in Intensive Care Units.
abstract: OBJECTIVE
  This study compared the catheter-associated urinary tract infection (CAUTI) rates resulting from the use of four perineal care agents (soap-and-water, skin cleansing foam, 10% povidone-iodine, and normal saline) among patients in intensive care units (ICUs).
  
  
  METHODS
  This four-group experimental study was done with 97 adult patients who had urinary catheters over 2 days in three ICUs between April and July 2008. The patients received one of the four types of perineal care. Data collected included the incidence of CAUTI at baseline (prior to perineal care) and 1 week, 2 weeks, and 4 weeks after beginning perineal care. Patients were divided into UTI and non-UTI groups based on the Centers for Disease Control and Prevention/National Healthcare Safety Network UTI definition to calculate incidence rates. The hazard ratio (HR) and 95% confidence intervals were calculated by Cox's proportional hazard analysis.
  
  
  RESULTS
  The cumulative incidence of CAUTIs per 100 urinary catheter days were 3.18 episodes during 1 week with urinary catheter, 3.31 during 2 weeks, and 3.04 during 4 weeks. No statistically significant difference in hazard ratios of CAUTIs for each perineal care agent was evident with reference to soap-and-water at 1 week, 2 weeks, and 4 weeks after beginning perineal care after controlling for age, use of antibiotics, fecal incontinence, consciousness level, fever, and diabetes.
  
  
  CONCLUSIONS
  The type of perineal care does not influence the incidence of CAUTIs. Further confirmatory studies with a larger patient population should be conducted, as well as determining perineal agent preference.
authors.affiliation: Associate Professor, College of Nursing, Pusan National University, Busan, Korea.
authors.forename: Ihnsook
authors.initials: I
authors.lastname: Jeong
authors.affiliation: Team Manager, Department of Nursing, Pusan National University Yangsan Hospital, Yangsan, Korea.
authors.forename: Soonmi
authors.initials: S
authors.lastname: Park
authors.affiliation: Associate Professor, Department of Clinical Nursing, University of Ulsan, Seoul, Korea.
authors.forename: Jae Sim
authors.initials: JS
authors.lastname: Jeong
authors.affiliation: Team Manager, Department of Nursing, Pusan National University Hospital, Busan, Korea.
authors.forename: Duck Sun
authors.initials: DS
authors.lastname: Kim
authors.affiliation: Unit Manager, Department of Nursing, Pusan National University Hospital, Busan, Korea.
authors.forename: Young Sun
authors.initials: YS
authors.lastname: Choi
authors.affiliation: Team Manager, Department of Nursing, Pusan National University Yangsan Hospital, Yangsan, Korea.
authors.forename: Young Soon
authors.initials: YS
authors.lastname: Lee
authors.affiliation: Unit Manager, Department of Nursing, Pusan National University Hospital, Busan, Korea.
authors.forename: Young Mi
authors.initials: YM
authors.lastname: Park