title: Catheter-Associated Urinary Tract Infections in Intensive Care Unit Patients.
abstract: OBJECTIVE
  To delineate the epidemiology of catheter-associated urinary tract infections (CAUTIs) and to better understand the value of urine cultures for evaluation of fever in the intensive care unit (ICU) setting
  
  
  METHODS
  Two-year retrospective review (2012-2013) SETTING: A single tertiary center with 1,200 hospital beds and 158 adult ICU beds
  
  
  METHODS
  ICU patients with a CAUTI event
  
  
  METHODS
  The cohort was identified from a prospective infection prevention database. Charts were reviewed to characterize the patients. CAUTI rates and device utilization ratio (DUR) were calculated. Clinical outcomes were recorded.
  
  
  RESULTS
  A total of 105 CAUTIs were identified using the National Health and Safety Network (NHSN) definition. Fever was the primary indication for obtaining urine culture in 102 patients (97%). Of these 105 patients, 51 (51%) had an alternative infection to explain the fever, with pneumonia (55%) being the most common followed by bloodstream infection (22%). A total of 18 patients (18%) had fever due to noninfectious cause, and 32 patients (32%) had no alternative explanation. Of these, 66% received appropriate empiric antimicrobial therapy, but no targeted therapy changes were made based on urine culture results. The other 34% did not receive antimicrobial therapy at all. Only 6% of all CAUTIs resulted in blood cultures positive for the same organism within 2 days. The urinary tract was not definitely established as the source of bloodstream infection.
  
  
  CONCLUSIONS
  Urine cultures obtained for evaluation of fever form the basis for identification of CAUTIs in the ICU. However, most patients with CAUTIs are eventually found to have alternative explanations for fever. CAUTI is associated with a low complication rate.
authors.affiliation: 1Division of Critical Care Medicine,Mayo Clinic,Rochester,Minnesota.
authors.forename: Rudy
authors.initials: R
authors.lastname: Tedja
authors.affiliation: 3Infection Prevention and Control,Mayo Clinic,Rochester,Minnesota.
authors.forename: Jean
authors.initials: J
authors.lastname: Wentink
authors.affiliation: 2Division of Infectious Disease,Mayo Clinic,Rochester,Minnesota.
authors.forename: John C
authors.initials: JC
authors.lastname: O'Horo
authors.affiliation: 2Division of Infectious Disease,Mayo Clinic,Rochester,Minnesota.
authors.forename: Rodney
authors.initials: R
authors.lastname: Thompson
authors.affiliation: 2Division of Infectious Disease,Mayo Clinic,Rochester,Minnesota.
authors.forename: Priya
authors.initials: P
authors.lastname: Sampathkumar
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D055499:Catheter-Related Infections / Q000097:blood*; D002648:Child; D002675:Child, Preschool; D003428:Cross Infection / Q000097:blood*; D016208:Databases, Factual; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D008910:Minnesota; D011014:Pneumonia / Q000453:epidemiology*; D012189:Retrospective Studies; D062606:Tertiary Care Centers; D014552:Urinary Tract Infections / Q000453:epidemiology*; D055815:Young Adult