title: Risk Factors for Bacteremia in Patients With Urinary Catheter-Associated Bacteriuria.
abstract: Catheter-associated bacteriuria is complicated by secondary bacteremia in 0.4% to 4.0% of cases. The directly attributable mortality rate is 12.7%.
  
  
  
  To identify risk factors for bacteremia associated with catheter-associated bacteriuria.
  
  
  
  Data were acquired from a large electronic clinical and administrative database of consecutive adult inpatient admissions to 2 acute care hospitals during a 7-year period. Data on patients with catheter-associated bacteriuria and bacteremia were compared with data on control patients with catheter-associated bacteriuria and no bacteremia, matched for date of admission plus or minus 30 days. Urine and blood cultures positive for the same pathogen within 7 days were used to define catheter-associated bacteriuria and bacteremia. Multivariable conditional logistic regression was used to determine independent risk factors for bacteremia.
  
  
  
  The sample consisted of 158 cases and 474 controls. Independent predictors of bacteremia were male sex (odds ratio, 2.76), treatment with immunosuppressants (odds ratio, 1.68), urinary tract procedure (odds ratio, 2.70), and catheter that remained in place after bacteriuria developed (odds ratio, 2.75). Patients with enterococcal bacteriuria were half as likely to become bacteremic as were patients with other urinary pathogens (odds ratio, 0.46). Odds of secondary bacteremia increased 2% per additional day of hospital stay (95% CI, 1.01-1.04) and decreased 1% with each additional year of age (95% CI, 0.97-0.99).
  
  
  
  The results add new information about increased risk for bacteremia among patients with catheters remaining in place after catheter-associated bacteriuria and confirm evidence for previously identified risk factors.
authors.affiliation: Laurie J. Conway is an assistant professor, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Canada. Jianfang Liu is a senior data analyst, Columbia University School of Nursing, New York, New York. Anthony D. Harris is a professor of epidemiology and public health, School of Medicine, University of Maryland, Baltimore. Elaine L. Larson is associate dean for research and professor of therapeutic and pharmaceutical research, School of Nursing, and professor of epidemiology, Mailman School of Public Health, Columbia University, New York, New York. laurie.conway@utoronto.ca.
authors.forename: Laurie J
authors.initials: LJ
authors.lastname: Conway
authors.affiliation: Laurie J. Conway is an assistant professor, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Canada. Jianfang Liu is a senior data analyst, Columbia University School of Nursing, New York, New York. Anthony D. Harris is a professor of epidemiology and public health, School of Medicine, University of Maryland, Baltimore. Elaine L. Larson is associate dean for research and professor of therapeutic and pharmaceutical research, School of Nursing, and professor of epidemiology, Mailman School of Public Health, Columbia University, New York, New York.
authors.forename: Jianfang
authors.initials: J
authors.lastname: Liu
authors.affiliation: Laurie J. Conway is an assistant professor, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Canada. Jianfang Liu is a senior data analyst, Columbia University School of Nursing, New York, New York. Anthony D. Harris is a professor of epidemiology and public health, School of Medicine, University of Maryland, Baltimore. Elaine L. Larson is associate dean for research and professor of therapeutic and pharmaceutical research, School of Nursing, and professor of epidemiology, Mailman School of Public Health, Columbia University, New York, New York.
authors.forename: Anthony D
authors.initials: AD
authors.lastname: Harris
authors.affiliation: Laurie J. Conway is an assistant professor, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Canada. Jianfang Liu is a senior data analyst, Columbia University School of Nursing, New York, New York. Anthony D. Harris is a professor of epidemiology and public health, School of Medicine, University of Maryland, Baltimore. Elaine L. Larson is associate dean for research and professor of therapeutic and pharmaceutical research, School of Nursing, and professor of epidemiology, Mailman School of Public Health, Columbia University, New York, New York.
authors.forename: Elaine L
authors.initials: EL
authors.lastname: Larson
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000209:etiology*; D001437:Bacteriuria / Q000150:complications*; D055499:Catheter-Related Infections / Q000150:complications*; D015897:Comorbidity; D003428:Cross Infection / Q000150:complications*; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D007362:Intensive Care Units; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors; D062885:Urinary Catheters