title: Eliminating catheter-associated urinary tract infections in the intensive care unit: is it an attainable goal?
abstract: BACKGROUND
  Purpose of this study is to determine strategies to decrease catheter-associated urinary tract infection (CAUTI) in intensive care unit (ICU) patients.
  
  
  METHODS
  ICU patients with an indwelling urinary catheter (UC) in one tertiary hospital were monitored for CAUTI. Interventions were implemented sequentially with quarterly data collection. Outcome measures were infection ratio (IR = number of infections/catheter days [CD] × 1000) and device utilization rate (DUR = catheter days/patient days).
  
  
  RESULTS
  CDs and DUR decreased (fiscal year 2008: CD, 11,414; DUR, .85 vs fiscal year 2013: CD, 8,144; DUR, .70). IR increased with suspension of prepackaged baths (IR, 3.2 to 3.5 to 4.9 to 5.0), twice daily UC care (IR, 4.8 to 6.7), emptying UC bags at 400 mL (IR, 6.7 to 9.2). Two-person UC placement (IR, 5.6 to 4.8), physician notification of CAUTI (IR, 6.1 to 4.8), and reinstitution of prepackaged baths and daily UC care (IR, 4.8 to 3.7) decreased CAUTI rates.
  
  
  CONCLUSIONS
  Decreasing CAUTI in the ICU requires diligent monitoring and constant practice re-evaluation. Elimination of CAUTI in the ICU may not be possible.
authors.affiliation: Trauma Service, Scripps Memorial Hospital La Jolla, 9888 Genesee Avenue, LJ601, La Jolla, CA 92037, USA. Electronic address: tominaga.gail@scrippshealth.org.
authors.forename: Gail T
authors.initials: GT
authors.lastname: Tominaga
authors.affiliation: Critical Care Service, Scripps Memorial Hospital La Jolla, 9888 Genesee Avenue, LJ601, La Jolla, CA 92037, USA.
authors.forename: Achal
authors.initials: A
authors.lastname: Dhupa
authors.affiliation: Critical Care Service, Scripps Memorial Hospital La Jolla, 9888 Genesee Avenue, LJ601, La Jolla, CA 92037, USA.
authors.forename: Sonja M
authors.initials: SM
authors.lastname: McAllister
authors.affiliation: Critical Care Service, Scripps Memorial Hospital La Jolla, 9888 Genesee Avenue, LJ601, La Jolla, CA 92037, USA.
authors.forename: Robin
authors.initials: R
authors.lastname: Calara
authors.affiliation: Infection Control, Scripps Memorial Hospital La Jolla, 9888 Genesee Avenue, LJ601, La Jolla, CA 92037, USA.
authors.forename: Stacie A
authors.initials: SA
authors.lastname: Peters
authors.affiliation: Infection Control, Scripps Memorial Hospital La Jolla, 9888 Genesee Avenue, LJ601, La Jolla, CA 92037, USA.
authors.forename: Amy
authors.initials: A
authors.lastname: Stuck
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D055499:Catheter-Related Infections / Q000453:epidemiology / Q000517:prevention & control*; D002408:Catheters, Indwelling; D003428:Cross Infection / Q000453:epidemiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology; D014552:Urinary Tract Infections / Q000453:epidemiology / Q000517:prevention & control*
keywords: Catheter-associated urinary tract infection (CAUTI); Indwelling urinary catheter; Intensive care unit; Urinary catheter utilization