AJIC: American Journal of Infection Control
Volume 34, Issue 7 , Pages 401-407 , September 2006

Risk factors for nosocomial urinary tract–related bacteremia: A case-control study

  • Sanjay Saint, MD, MPH

      Affiliations

    • From the Center for Practice Management and Outcomes Research, Ann Arbor VA Health Services Research and Development Center of Excellence, Ann Arbor, MI
    • Division of General Medicine, University of Michigan Department of Internal Medicine, Ann Arbor, MI
    • VA/UM Patient Safety Enhancement Program, Ann Arbor, MI
    • Corresponding Author InformationReprint request: Sanjay Saint, MD, MPH, Room 7E08, 300 NIB - Campus Box 0429, Ann Arbor, MI 48109-0429.
  • ,
  • Samuel R. Kaufman, MA

      Affiliations

    • Division of General Medicine, University of Michigan Department of Internal Medicine, Ann Arbor, MI
    • VA/UM Patient Safety Enhancement Program, Ann Arbor, MI
  • ,
  • Mary A.M. Rogers, PhD

      Affiliations

    • Division of General Medicine, University of Michigan Department of Internal Medicine, Ann Arbor, MI
    • VA/UM Patient Safety Enhancement Program, Ann Arbor, MI
  • ,
  • Paul D. Baker, ARNP

      Affiliations

    • Veterans Affairs Puget Sound Health Care System, Seattle Division, Seattle, WA
  • ,
  • Edward J. Boyko, MD, MPH

      Affiliations

    • Veterans Affairs Puget Sound Health Care System, Seattle Division, Seattle, WA
    • Department of Medicine, University of Washington School of Medicine, Seattle, WA
  • ,
  • Benjamin A. Lipsky, MD

      Affiliations

    • Veterans Affairs Puget Sound Health Care System, Seattle Division, Seattle, WA
    • Department of Medicine, University of Washington School of Medicine, Seattle, WA

References 

  1. Haley RW, Culver DH, White JW, Morgan WM, Emori TG. The nationwide nosocomial infection rate: a new need for vital statistics. Am J Epidemiol. 1985;121:159–167
  2. Warren JW. The catheter and urinary tract infection. Med Clin North Am. 1991;75:481–493
  3. Maki DG. Nosocomial bacteremia: an epidemiologic overview. Am J Med. 1981;70:719–732
  4. Weinstein MP, Towns ML, Quartey SM, Mirrett S, Reimer LG, Parmigiani G, et al. The clinical significance of positive blood cultures in the 1990s: a prospective comprehensive evaluation of the microbiology, epidemiology, and outcome of bacteremia and fungemia in adults. Clin Infect Dis. 1997;24:584–602
  5. Anonymous. National Nosocomial Infections Surveillance (NNIS) report, data summary from October 1986-April 1996, issued May 1996. A report from the National Nosocomial Infections Surveillance (NNIS) System. Am J Infect Control 1996;24:380-8.
  6. Saint S, Wiese J, Amory JK, Bernstein ML, Patel UD, Zemencuk JK, et al. Are physicians aware of which of their patients have indwelling urinary catheters?. Am J Med. 2000;109:476–480
  7. Haley RW, Hooton TM, Culver DH, Stanley RC, Emori TG, Hardison CD, et al. Nosocomial infections in U.S. hospitals, 1975-1976: estimated frequency by selected characteristics of patients. Am J Med. 1981;70:947–959
  8. Bryan CS, Reynolds KL. Hospital-acquired bacteremic urinary tract infection: epidemiology and outcome. J Urol. 1984;132:494–498
  9. Krieger JN, Kaiser DL, Wenzel RP. Urinary tract etiology of bloodstream infections in hospitalized patients. J Infect Dis. 1983;148:57–62
  10. Saint S. Clinical and economic consequences of nosocomial catheter-related bacteriuria. Am J Infect Control. 2000;28:68–75
  11. Hustinx WN, Mintjes de Groot AJ, Verkooyen RP, Verbrugh HA. Impact of concurrent antimicrobial therapy on catheter-associated urinary tract infection. J Hosp Infect. 1991;18:45–56
  12. Garibaldi RA, Burke JP, Dickman ML, Smith CB. Factors predisposing to bacteriuria during indwelling urethral catheterization. N Engl J Med. 1974;291:215–219
  13. Platt R, Polk BF, Murdock B, Rosner B. Risk factors for nosocomial urinary tract infection. Am J Epidemiol. 1986;124:977–985
  14. Shapiro M, Simchen E, Izraeli S, Sacks TG. A multivariate analysis of risk factors for acquiring bacteriuria in patients with indwelling urinary catheters for longer than 24 hours. Infect Control. 1984;5:525–532
  15. Saint S, Lipsky BA. Preventing catheter-related bacteriuria: Can we? Should we? How?. Arch Intern Med. 1999;159:800–808
  16. Saint S, Chenoweth CE. Biofilms and catheter-associated urinary tract infections. Infect Dis Clin North Am. 2003;17:411–432
  17. Pittet D, Tarara D, Wenzel RP. Nosocomial bloodstream infection in critically ill patients: excess length of stay, extra costs, and attributable mortality. [see comments] JAMA. 1994;271:1598–1601
  18. Saint S, Savel RH, Matthay MA. Enhancing the safety of critically ill patients by reducing urinary and central venous catheter-related infections. Am J Respir Crit Care Med. 2002;165:1475–1479
  19. Lipsky BA, Ireton RC, Fihn SD, Hackett R, Berger RE. Diagnosis of bacteriuria in men: specimen collection and culture interpretation. J Infect Dis. 1987;155:847–854
  20. Stark RP, Maki DG. Bacteriuria in the catheterized patient. What quantitative level of bacteriuria is relevant?. N Engl J Med. 1984;311:560–564
  21. Saint S, Zemencuk JK, Chenoweth CE, Lipsky BA, Baker PD, Plorde JJ. The potential benefit of infectious diseases consultation in patients with community-acquired bacteremia. J Clin Outcomes Manage. 2001;12:1–8
  22. Lark RL, Chenoweth C, Saint S, Zemencuk JK, Lipsky BA, Plorde JJ. Four-year prospective evaluation of nosocomial bacteremia: epidemiology, microbiology, and patient outcome. Diagn Microbiol Infect Dis. 2000;38:131–140
  23. Lark RL, Saint S, Chenoweth C, Zemencuk JK, Lipsky BA, Plorde JJ. Four-year prospective evaluation of community-acquired bacteremia: epidemiology, microbiology, and patient outcome. Diagn Microbiol Infect Dis. 2001;41:15–22
  24. Hugonnet S, Sax H, Eggimann P, Chevrolet JC, Pittet D. Nosocomial bloodstream infection and clinical sepsis. Emerg Infect Dis. 2004;10:76–81
  25. Weber RS, Hankins P, Rosenbaum B, Raad I. Nonwound infections following head and neck oncologic surgery. Laryngoscope. 1993;103:22–27
  26. Thalgott JS, Cotler HB, Sasso RC, LaRocca H, Gardner V. Postoperative infections in spinal implants: classification and analysis–a multicenter study. Spine. 1991;16:981–984
  27. Sorensen LT, Karlsmark T, Gottrup F. Abstinence from smoking reduces incisional wound infection: a randomized controlled trial. Ann Surg. 2003;238:1–5
  28. El Ahmer OR, Essery SD, Saadi AT, Raza MW, Ogilvie MM, Weir DM, et al. The effect of cigarette smoke on adherence of respiratory pathogens to buccal epithelial cells. FEMS Immunol Med Microbiol. 1999;23:27–36
  29. Morrison AS, Buring JE, Verhoek WG, Aoki K, Leck I, Ohno Y, et al. An international study of smoking and bladder cancer. J Urol. 1984;131:650–654
  30. Tripathi A, Folsom AR, Anderson KE. The Iowa Women's Health Study. Risk factors for urinary bladder carcinoma in postmenopausal women. Cancer. 2002;95:2316–2323
  31. Auerbach O, Garfinkel L. Histologic changes in the urinary bladder in relation to cigarette smoking and use of artificial sweeteners. Cancer. 1989;64:983–987
  32. Jensen AG, Wachmann CH, Poulsen KB, Espersen F, Scheibel J, Skinhoj P, et al. Risk factors for hospital-acquired Staphylococcus aureus bacteremia. Arch Intern Med. 1999;159:1437–1444
  33. Valles J, Rello J, Ochagavia A, Garnacho J, Alcala MA. Community-acquired bloodstream infection in critically ill adult patients: impact of shock and inappropriate antibiotic therapy on survival. Chest. 2003;123:1615–1624
  34. Gibson J, Johnson L, Snowdon L, Joshua D, Young G, MacLeod C, et al. Trends in bacterial infections in febrile neutropenic patients: 1986-1992. Aust N Z J Med. 1994;24:374–377
  35. Jerkeman M, Braconier JH. Bacteremic and non-bacteremic febrile urinary tract infection–a review of 168 hospital-treated patients. Infection. 1992;20:143–145
  36. Kelsey JL, Whittemore AS, Evans AS, Thompson WD. Methods in observational epidemiology. 2nd ed.. New York, New York: Oxford University Press; 1996;
  37. Gerberding JL. Hospital-onset infections: a patient safety issue. Ann Intern Med. 2002;137:665–670
  38. Burke JP. Patient safety: infection control–a problem for patient safety. N Engl J Med. 2003;348:651–656
  39. Lyytikainen O, Lumio J, Sarkkinen H, Kolho E, Kostiala A, Ruutu P, et al. Nosocomial bloodstream infections in Finnish hospitals during 1999-2000. Clin Infect Dis. 2002;35:e14–e19

 Supported by a Department of Veterans Affairs Epidemiologic Research and Information Center research grant (EPP-97-015; to B.A.L. and S.S.), a Career Development Award from the Health Services Research and Development Program of the Department of Veterans Affairs (to S.S.), and a Patient Safety Developmental Center Grant from the Agency for Healthcare Research and Quality (P20-HS11540; to S.S.).Preliminary results of this study were presented at the 41st Annual Meeting of the Infectious Diseases Society of America in San Diego, CA, on October 11, 2003, and the 27th Annual Meeting of the Society of General Internal Medicine in Chicago, IL, on May 13, 2004.

PII: S0196-6553(06)00138-6

doi: 10.1016/j.ajic.2006.03.001

AJIC: American Journal of Infection Control
Volume 34, Issue 7 , Pages 401-407 , September 2006