title: Risk Factors for Catheter Associated Urinary Tract Infections in a Pediatric Institution.
abstract: OBJECTIVE
  Catheter associated urinary tract infections are an essential measure for health care quality improvement that affects reimbursement through hospital acquired condition reduction programs in adult patients. With the mounting importance of preventing such infections we evaluated risk factors for acquiring catheter associated urinary tract infections in pediatric patients.
  
  
  METHODS
  All catheter associated urinary tract infections were identified at 1 pediatric institution from September 2010 to August 2014 from a prospective database maintained by the infection control office. To identify risk factors patients with a catheter associated urinary tract infection were individually matched to control patients with a urinary catheter but without infection by age, gender, date and the hospital location of the infection in 1:2 fashion.
  
  
  RESULTS
  A total of 50 patients with catheter associated urinary tract infection were identified and matched to 100 control patients. Compared to controls the patients with infection were more likely to have a catheter in place for longer (2.9 days, OR 1.08, 95% CI 1.01, 1.15, p = 0.02). They were also more likely to be on contact precautions (OR 4.00, 95% CI 1.73, 9.26, p = 0.001), and have concurrent infections (OR 3.04, 95% CI 1.39, 6.28, p = 0.005) and a history of catheterization (OR 3.24, 95% CI 1.55, 6.77, p = 0.002). Using a conditional multivariate regression model the 3 most predictive variables were duration of catheter drainage, contact isolation status and history of catheterization.
  
  
  CONCLUSIONS
  Longer duration of urinary catheter drainage, positive contact precautions status and a history of catheterization appear to be associated with a higher risk of catheter associated urinary tract infection in hospitalized pediatric patients. Physicians should attempt to decrease the duration of catheterization, especially in patients who meet these criteria, to minimize the risk of catheter associated urinary tract infection.
authors: Division of Urology, Children's National Medical Center, Washington, D.C.. Electronic address: noraglee@gmail.com.
authors: Nora G
authors: NG
authors: Lee
authors: Division of Urology, Children's National Medical Center, Washington, D.C.
authors: Daniel
authors: D
authors: Marchalik
authors: Department of Internal Medicine, Montefiore Medical Center, New York, New York.
authors: Andrew
authors: A
authors: Lipsky
authors: Division of Urology, Children's National Medical Center, Washington, D.C.
authors: H Gil
authors: HG
authors: Rushton
authors: Division of Urology, Children's National Medical Center, Washington, D.C.
authors: Hans G
authors: HG
authors: Pohl
authors: Division of Infectious Diseases, Children's National Medical Center, Washington, D.C.
authors: Xiaoyan
authors: X
authors: Song
mesh_terms: D055499:Catheter-Related Infections / Q000453:epidemiology* / Q000209:etiology*; D002648:Child; D003428:Cross Infection / Q000453:epidemiology* / Q000209:etiology*; D005260:Female; D006776:Hospitals, Pediatric; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D014546:Urinary Catheterization / Q000009:adverse effects*; D014552:Urinary Tract Infections / Q000453:epidemiology* / Q000209:etiology*
keywords: catheterization; cross infection; hospitals; risk; urinary tract infections