Efficacy of Antimicrobial Catheters for Prevention of Catheter-Associated Urinary Tract Infection in Acute Cerebral Infarction
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- Muramatsu Keiji
- Department of Preventive Medicine and Community Health, School of Medicine, University of Occupational and Environmental Health
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- Fujino Yoshihisa
- Department of Preventive Medicine and Community Health, School of Medicine, University of Occupational and Environmental Health Data Science Center of Occupational Health, University of Occupational and Environmental Health
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- Kubo Tatsuhiko
- Department of Preventive Medicine and Community Health, School of Medicine, University of Occupational and Environmental Health
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- Otani Makoto
- Data Science Center of Occupational Health, University of Occupational and Environmental Health
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- Fushimi Kiyohide
- Department of Health Policy and Informatics, Tokyo Medical and Dental University Graduate School
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- Matsuda Shinya
- Department of Preventive Medicine and Community Health, School of Medicine, University of Occupational and Environmental Health Data Science Center of Occupational Health, University of Occupational and Environmental Health
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<p>Background: Catheter-associated urinary tract infection (CAUTI) is a common nosocomial infection. However, the effectiveness of antimicrobial catheters in reducing CAUTI in cerebral infarction patients is unknown. The purpose of this study was to determine whether antimicrobial catheters protect against CAUTI in cerebral infarction patients.</p><p>Methods: We identified 27,548 patients from the Japanese Diagnosis Procedure Combination Database who had been admitted from April 1, 2012 through March 31, 2014 for acute management of cerebral infarction and had used at least an indwelling urethral catheter. We extracted data on patient sex, age, comorbidity, length of stay, activities of daily living (ADL), surgery, hospital case volume, and catheter type. We defined CAUTI as a urinary tract infection arising during admission. We performed multi-level logistic regression analysis to analyze the reduction in CAUTI using antimicrobial catheters.</p><p>Results: The rate of CAUTI was 8.8% and 8.3% in the control and antimicrobial catheter groups, respectively. Significant risk factors for CAUTI were age, diabetes requiring insulin therapy, low ADL score, and long hospitalization. Incidence rate was significantly lower in operated cases and those treated with tissue plasminogen activator. For all cases overall, the use of an antimicrobial catheter was not associated with a lower CAUTI rate. However, use was associated with a lower rate of CAUTI in diabetic patients on insulin.</p><p>Conclusions: Antimicrobial catheter use was not associated with a lower incidence rate of CAUTI in acute cerebral infarction patients. However, stratified analysis suggested that use was associated with a lower incidence in diabetic patients on insulin.</p>
収録刊行物
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- Ｊｏｕｒｎａｌ ｏｆ Ｅｐｉｄｅｍｉｏｌｏｇｙ
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Ｊｏｕｒｎａｌ ｏｆ Ｅｐｉｄｅｍｉｏｌｏｇｙ 28 (1), 54-58, 2018
日本疫学会