title: Catheter-associated urinary tract infection (CAUTI) after term cesarean delivery: incidence and risk factors at a multi-center academic institution.
abstract: OBJECTIVE
  The purpose of this study is to identify the rate of catheter-associated urinary tract infection (CAUTI) after Cesarean delivery (CD) and to determine if any factors increase risk of infection.
  
  
  METHODS
  A retrospective cohort study was performed at a multi-center institution for patients who underwent CD in 2013. All patients had urinary catheters inserted before surgery. Diagnosis followed IDSA guidelines with culture growing greater than 103CFU of bacteria per mL with symptoms or symptomatic urinary tract infections treated at provider discretion. Statistical analysis was assessed with Chi-square and Student's t-test followed by logistic regression.
  
  
  RESULTS
  Of 2419 patients, 36 patients developed CAUTI (1.5%). In the 24 (66.7%) cases diagnosed by IDSA guidelines, Escherichia coli was the most common causative organism (54.1%); followed by Enterococcus faecalis (16.7%), Streptococccus agalactiae (8.3%), and Group A Streptococcus (8.3%). Longer operative time (OR 1.013; 95% 1.002-1.023; p = .02) and pregnancies complicated by STI (OR 4.15; 95% CI 1.11-15.0; p < .05) were associated with higher rates of CAUTI.
  
  
  CONCLUSIONS
  The overall rate of CAUTI after CD was low at 1.5%. Escherichia coli was the most common causative pathogen. Identification of the patients at high risk for CAUTI allows for risk reduction measures.
authors.affiliation: a Obstetrics, Gynecology and Women's Health Institute, Cleveland Clinic , Cleveland , OH , USA.
authors.forename: Laura
authors.initials: L
authors.lastname: Moulton
authors.affiliation: b Department of Gynecology and Obstetrics , Emory University School of Medicine , Atlanta , GA , USA.
authors.forename: Mark
authors.initials: M
authors.lastname: Lachiewicz
authors.affiliation: c Department of Quantitative Health Sciences , Cleveland Clinic , Cleveland , OH , USA.
authors.forename: Xiaobo
authors.initials: X
authors.lastname: Liu
authors.affiliation: a Obstetrics, Gynecology and Women's Health Institute, Cleveland Clinic , Cleveland , OH , USA.
authors.forename: Oluwatosin
authors.initials: O
authors.lastname: Goje
mesh_terms: D000328:Adult; D002585:Cesarean Section; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D006801:Humans; D015994:Incidence; D009820:Ohio / Q000453:epidemiology; D011247:Pregnancy; D011645:Puerperal Infection / Q000453:epidemiology* / Q000382:microbiology; D012189:Retrospective Studies; D012307:Risk Factors; D014546:Urinary Catheterization / Q000009:adverse effects*; D014552:Urinary Tract Infections / Q000453:epidemiology* / Q000382:microbiology
keywords: Catheter-associated urinary tract infection; cesarean delivery; nosocomial infection; postpartum infection