298. Catheter-associated Urinary Tract Infections Attributed to Yeast Reported to the Centers for Disease Control and Preventionís National Healthcare Safety Network, 2014
Session: Poster Abstract Session: HAI: Device Associated Infections
Thursday, October 8, 2015
Room: Poster Hall
Posters
  • Lyman--Final CAUTI Poster.pdf (207.6 kB)
  • Background: Urine colonization by yeast rarely results in clinically significant urinary tract infection (UTI). To improve standardization, clinical relevance, and prevention focus of reporting catheter-associated UTI (CAUTI) to the National Healthcare Safety Network (NHSN) surveillance system, CDC introduced changes to the UTI surveillance criteria in January 2015, including the removal of yeast (and other non-bacterial organisms) from the UTI criteria. The objective of this analysis is to describe the prevalence of CAUTIs attributed to yeast reported from acute care hospital intensive care unit (ICU) and ward locations in 2014.

    Methods: More than 4,000 facilities reported data to NHSN using standard methods to identify CAUTI events (symptomatic UTI or asymptomatic bacteremic UTI). Data from adult and pediatric ICUs and wards (including step-down units) were aggregated to describe the prevalence of CAUTIs due to yeast and reported secondary bloodstream infections by location and pathogen. We evaluated differences in the distribution of species in ICU and ward locations using Pearson’s chi-square.

    Results: Yeast alone accounted for 8,305 (33%) of the 24,887 CAUTIs reported from ICUs and 2,423 (20%) of the 12,026 CAUTIs from wards. Among the yeasts reported, 72% were identified as Candida spp, of which the species was identified in 91%; the most common species were C. albicans (73%), C. glabrata (16%), and C. tropicalis (7%). There was no statistical difference in the distribution of species reported by location (p=0.2). Of the CAUTIs attributed to yeast, 4% were reported to have secondary bloodstream infections (fungemia), compared to 6% of all other CAUTIs.

    Conclusion: Overall, 29% of CAUTIs reported to NHSN were attributed to yeast only. Changes to the NHSN UTI criteria, including removal of yeast, will likely impact CAUTI rates and standardized infection ratios. To evaluate the impact of prevention efforts across this definition change, longitudinal trends can be estimated by retrospectively excluding CAUTIs that no longer meet the criteria. In addition, the potential impact of CAUTI definition changes on reported central line-associated bloodstream infection rates should be tracked, as fungemia can no longer be attributed to a urinary source.

    Meghan Lyman, MD1,2, Alison S. Laufer-Halpin, Ph.D.3, Lindsey M. Weiner, MPH3, Jonathan R. Edwards, MStat3, Kelly Peterson, BBA3, Margaret Dudeck, MPH, CPH4, Katherine Allen-Bridson, RN, BSN, MScPH, CIC5 and Carolyn Gould, MD, MSCR3, (1)Division for Healthcare Quality Promotion, Center for Disease Control and Prevention, Atlanta, GA, (2)Epidemic Intelligence Service, Center for Disease Control and Prevention, Atlanta, GA, (3)Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, GA, (4)Divison of Healthcare Quality Promotion, Center for Disease Control and Prevention, Atlanta, GA, (5)Centers for Disease Control and Prevention, Atlanta, GA

    Disclosures:

    M. Lyman, None

    A. S. Laufer-Halpin, None

    L. M. Weiner, None

    J. R. Edwards, None

    K. Peterson, None

    M. Dudeck, None

    K. Allen-Bridson, None

    C. Gould, None

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 7th with the exception of research findings presented at the IDWeek press conferences.