title: Risk factors for urinary catheter associated bloodstream infection.
abstract: OBJECTIVE
  Urinary catheter associated bloodstream infection (UCABSI) causes significant morbidity, mortality and healthcare costs. We aimed to define the risk factors for UCABSI.
  
  
  METHODS
  A case-control study was conducted at two Australian tertiary hospitals. Patients with urinary source bloodstream infection associated with an indwelling urinary catheter (IDC) were compared to controls with an IDC who did not develop urinary source bloodstream infection.
  
  
  RESULTS
  There were 491 controls and 67 cases included in the analysis. Independent statistically significant risk factors for the development of UCABSI included insertion of the catheter in operating theatre, chronic kidney disease, age-adjusted Charlson comorbidity index, accurate urinary measurements as reason for IDC insertion and dementia. IDCs were inserted for valid reasons in nearly all patients, however an appropriate indication at 48 h post-insertion was found in only 44% of patients. Initial empiric antibiotics were deemed inappropriate in 23 patients (34%).
  
  
  CONCLUSIONS
  To our knowledge, this is the first study to look specifically at the risk factors for bloodstream infection in urinary catheterised patients. Several risk factors were identified. IDC management and empiric management of UCABSI could be improved and is likely to result in a decreased incidence of infection and its complications.
authors.affiliation: Infection Management Services, Princess Alexandra Hospital, Woolloongabba, Brisbane 4102, Australia; University of Queensland, School of Medicine, Brisbane, Queensland, Australia. Electronic address: evanbursle@gmail.com.
authors.forename: Evan C
authors.initials: EC
authors.lastname: Bursle
authors.affiliation: Infection Management Services, Princess Alexandra Hospital, Woolloongabba, Brisbane 4102, Australia; University of Queensland, School of Medicine, Brisbane, Queensland, Australia. Electronic address: jane.dyer@health.qld.gov.au.
authors.forename: Jane
authors.initials: J
authors.lastname: Dyer
authors.affiliation: Infection Management Services, Princess Alexandra Hospital, Woolloongabba, Brisbane 4102, Australia; University of Queensland, School of Medicine, Brisbane, Queensland, Australia. Electronic address: david.looke@health.qld.gov.au.
authors.forename: David F M
authors.initials: DF
authors.lastname: Looke
authors.affiliation: Infection Management Services, Princess Alexandra Hospital, Woolloongabba, Brisbane 4102, Australia. Electronic address: david.mcdougall@health.qld.gov.au.
authors.forename: David A J
authors.initials: DA
authors.lastname: McDougall
authors.affiliation: University of Queensland Centre for Clinical Research, Royal Brisbane and Women's Hospital, Queensland 4006, Australia. Electronic address: david.paterson@health.qld.gov.au.
authors.forename: David L
authors.initials: DL
authors.lastname: Paterson
authors.affiliation: Infection Management Services, Princess Alexandra Hospital, Woolloongabba, Brisbane 4102, Australia; University of Queensland, School of Medicine, Brisbane, Queensland, Australia. Electronic address: geoffrey.playford@health.qld.gov.au.
authors.forename: E G
authors.initials: EG
authors.lastname: Playford
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001315:Australia / Q000453:epidemiology; D016470:Bacteremia; D016022:Case-Control Studies; D055499:Catheter-Related Infections / Q000188:drug therapy / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D014546:Urinary Catheterization / Q000009:adverse effects*; D062885:Urinary Catheters / Q000009:adverse effects*; D014552:Urinary Tract Infections / Q000188:drug therapy / Q000453:epidemiology*
chemical_list: D000900:Anti-Bacterial Agents
keywords: Bacteraemia; Bacteriuria; Bloodstream infection; Urinary catheter; Urinary tract infection