2109. Reducing Catheter Associated Urinary Infections (CAUTI) in the Intensive Care Unit (ICU): Changing the Culture of Culturing
Session: Poster Abstract Session: Healthcare Epidemiology: Device-associated HAIs
Saturday, October 6, 2018
Room: S Poster Hall
  • IIDSA 2018 2109 Reducing Catheter Associated Urinary Tract Infections (CAUTI) in the Intensive Care Unit (ICU) Changing the Culture of Culturing.pdf (130.1 kB)
  • Background:

    CAUTIs are one of the most common preventable adverse events in hospitalized patients. Prior to the start of this intervention, CAUTI rates in our ICU’s throughout our multicenter acute care system were significantly above the national average. Our hypothesis was that we could decrease CAUTI’s by daily review of the urine culture orders for patients with a Foley catheter


    We implemented guidelines for appropriate ordering of urine culture for patients with Foley catheters in 2014. The culture was deemed appropriate if the patient had a fever >100.4°F within 48 hours or leukocytosis with no other identifiable source of infection and has one or more of the following: costovertebral angle/flank pain, suprapubic pain, increase in urinary frequency; urgency, frequency or dysuria after catheter removal, acute mental status change, worsening of clinical status. The ordering prescriber was called to cancel the order that did not meet the urine culture ordering guideline. If the ordering prescriber questioned the guidelines, Epidemiologists intervened to explain the rationale. This was a prospective, observational study. Chi-Squared analysis was used to compare the reduction of CAUTIs


    The data showed sustained improvement. Compared to the 2012 baseline rate of 4.28 cases per 1000 device days, the 2013 rate was 2.70 (p=0.085), the 2014 rate was 1.38 (p=0.00046), the 2015 rate was 0.73 (p<0.0001), and the 2016 rate was 0.63 (p<0.0001).


    We found that using guidelines combined with an Infection Preventionist review to determine the appropriateness of urine cultures was associated with a significant reduction in the rate of ICU CAUTI’s. Real-time culture order review is a sustainable process that has continued the success of our CAUTI reduction program

    Mona Shah, MPH, CIC1, Cammy Hines, RN, CIC2, Michael O. Vernon, DrPH3, Kamaljit Singh, MD4 and Lance Peterson, MD3, (1)Infection Control and Prevention, NorthShore University HealthSystem, Evanston, IL, (2)Infection Control, Northshore University HealthSystem, Evanston, IL, (3)NorthShore University HealthSystem, Evanston, IL, (4)Pathology, Evanston Hospital/NorthShore University HealthSystem, Evanston, IL


    M. Shah, None

    C. Hines, None

    M. O. Vernon, None

    K. Singh, None

    L. Peterson, None

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 3rd with the exception of research findings presented at the IDWeek press conferences.