title: Risk factors for catheter-associated urinary tract infection in Italian elderly.
abstract: BACKGROUND
  Catheter-associated urinary tract infections (CAUTIs) are the most common cause of hospital-acquired infections, especially in elderly patients. Data on CAUTIs in older persons in acute care settings are lacking, however. This study aimed to describe the epidemiology of CAUTIs and related outcomes (ie, length of stay and mortality), in patients admitted to an acute geriatric care hospital in central Italy.
  
  
  METHODS
  A CAUTI surveillance program was implemented from October 2011 to April 2012, according to the Centers for Disease Control and Prevention's National Healthcare Safety Network methodology.
  
  
  RESULTS
  A total of 2773 patients aged ≥65 years were included in the study, and 483 catheterized patients were monitored for the risk of CAUTI. The catheterization rate was 16.7% (95% confidence interval [CI], 15.3%-18.2%), and the overall CAUTI incidence rate was 14.7/1000 device-days (95% CI, 11.7-18.3/1000). Mortality was significantly higher in catheterized patients with a CAUTI compared with noncatheterized patients (19.2% vs 10.5%; P < .05). Female sex (odds ratio [OR], 1.31; 95% CI, 1.06-1.67), increasing age (≥90 years: OR, 2.76; 95% CI, 2.00-3.83), and longer hospital stay before catheter insertion (≥15 days: OR, 2.90; 95% CI, 2.20-3.83) were independent risk factors for catheterization; increasing age (>90 years: OR, 2.75; 95% CI, 1.03-7.35), and duration of hospital stay before catheter insertion (OR, 2.41; 95% CI, 1.12-5.51) were associated with CAUTIs.
  
  
  CONCLUSIONS
  These results underscore the importance of the proper choice of patients for catheterization, particularly in individuals aged >90 years.
authors.affiliation: Medical Direction Department, National Institute for Health and Science on Ageing, Istituto Nazionale di Ricovero e Cura per Anziani-Istituto di Ricovero e Cura a Carattere Scientifico, Ancona, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Vincitorio
authors.affiliation: Department of Biomedical Sciences and Public Health, Section of Hygiene, Preventive Medicine and Public Health, Università Politecnica delle Marche, Ancona, Italy. Electronic address: p.barbadoro@univpm.it.
authors.forename: Pamela
authors.initials: P
authors.lastname: Barbadoro
authors.affiliation: Department of Biomedical Sciences and Public Health, Section of Hygiene, Preventive Medicine and Public Health, Università Politecnica delle Marche, Ancona, Italy.
authors.forename: Lucia
authors.initials: L
authors.lastname: Pennacchietti
authors.affiliation: Department of Biomedical Sciences and Public Health, Section of Hygiene, Preventive Medicine and Public Health, Università Politecnica delle Marche, Ancona, Italy.
authors.forename: Ilaria
authors.initials: I
authors.lastname: Pellegrini
authors.affiliation: Medical Direction Department, National Institute for Health and Science on Ageing, Istituto Nazionale di Ricovero e Cura per Anziani-Istituto di Ricovero e Cura a Carattere Scientifico, Ancona, Italy.
authors.forename: Serenella
authors.initials: S
authors.lastname: David
authors.affiliation: Department of Biomedical Sciences and Public Health, Section of Hygiene, Preventive Medicine and Public Health, Università Politecnica delle Marche, Ancona, Italy.
authors.forename: Elisa
authors.initials: E
authors.lastname: Ponzio
authors.affiliation: Department of Biomedical Sciences and Public Health, Section of Hygiene, Preventive Medicine and Public Health, Università Politecnica delle Marche, Ancona, Italy.
authors.forename: Emilia
authors.initials: E
authors.lastname: Prospero
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D055499:Catheter-Related Infections / Q000453:epidemiology*; D005260:Female; D006299:Health Services for the Aged; D006761:Hospitals; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008297:Male; D012307:Risk Factors; D016019:Survival Analysis; D014552:Urinary Tract Infections / Q000453:epidemiology*
keywords: Acute geriatric care; Health care-associated infection; Incidence rate; Morbidity; Mortality