706. External (condom) urinary catheters are associated with high rates of bacteriuria
Session: Poster Abstract Session: UTIs - Epidemiology and Prevention
Friday, October 21, 2011
Room: Poster Hall B1
Background:

Hospitals are focusing on reducing unnecessary use of indwelling urinary catheters.  Within the VA system, removal of a transurethral catheter often results in placement of a condom (external) urinary collection system.  We wanted to document use of condom catheters and their infectious complications, in comparison to indwelling urinary catheters. 

Methods:

We monitored all inpatients on 10 wards at HOU and 5 comparable wards at SA over a 6 month period.  The electronic medical records (EMR) at the Michael E. DeBakey VA Medical Center (HOU) and the South Texas Veterans Health Science Center (SA) were reviewed systemically 5 days a week for the presence of urinary catheters, collection of urine cultures, and urine culture results. Any bacteriuria or funguria reported by the microbiology laboratory was classified as a positive urine culture.

Results:

We observed 68,397 patient bed-days; on 25,954 (38%) of these days a urinary catheter was in use. The overall catheter-day rate was 379 per 1000 bed-days. Of these catheter-days, 49% were for indwelling and 47% were for external catheters.  During these 6 months, 3,172 urine cultures were sent from the monitored wards, and 1,131 (36%) of these urine cultures were positive.  Of these positive urine cultures, 553 (49%) were from catheterized patients, for a positive culture rate of 21 per 1000 catheter-days.  Of the positive urine cultures collected from catheterized patients, 335 (61%) were from indwelling and 189 (34%) were from condom catheters.

Conclusion:

We have documented an extensive prevalence of catheter use in 2 VA hospitals.  Catheter use was nearly evenly divided between indwelling and condom catheters.  Over one-third of catheter-associated bacteriuria/funguria arose from condom catheterization.  Catheter-associated bacteriuria/funguria, particularly condom catheter-associated bacteriuria/funguria, is a bigger problem than is widely appreciated.


Subject Category: N. Hospital-acquired and surgical infections, infection control, and health outcomes including general public health and health services research

Allison C. Burns, BS1, Armandina Garza, BS1, Jan E. Patterson, MD2,3, Patti Grota, PhD, RN, CIC2,3, Aanand Naik, MD1,4 and Barbara W. Trautner, MD, PhD1,5, (1)Department of Veterans Affairs, Health Services Research & Development Center of Excellence, Michael E. DeBakey VA Medical Center, Houston, TX, Houston, TX, (2)South Texas VA Health Care System, San Antonio, TX, (3)The University of Texas Health Science Center, San Antonio, TX, (4)Department of Medicine, Baylor College of Medicine, Houston, TX, (5)Baylor College of Medicine, Houston, TX

Disclosures:

A. C. Burns, None

A. Garza, None

J. E. Patterson, None

P. Grota, None

A. Naik, None

B. W. Trautner, None

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