Trends in catheter-associated urinary tract infections among a national cohort of hospitalized adults, 2001-2010

Background: Catheter-associated urinary tract infections (CAUTIs) have become a major public health concern in the United States. This study provides national estimates of CAUTI incidence, mortality, and associated hospital length of stay (LOS) over a 10-year period. Methods: This was a retrospective analysis of the National Hospital Discharge Surveys from 2001 to 2010. Adults age >= 18 years with an International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) procedure code for urinary catheter placement or other major procedure were included. Urinary tract infections were identified by ICD-9-CM code. Data weights were applied to derive national estimates. Predictors of CAUTI were identified using a logistic regression model. Results: These data represent 70.4 million catheterized patients, 3.8 million of whom developed a CAUTI. The incidence of CAUTIs decreased from 9.4 cases/100 catheterizations in 2001 to 5.3 cases/100 catheterizations in 2010. Mortality in patients with a CAUTI declined from 5.4% in 2001 to 3.7% in 2010. Median (interquartile range [IQR]) hospital LOS also declined, from 9 days (IQR, 5-16 days) in 2001 to 7 days (IQR, 4-12 days) in 2010. Independent predictors of CAUTI included female sex, emergency hospital admission, transfer from another facility, and Medicaid payment (P < .0001 for all variables). Conclusions: The incidence of CAUTIs in US hospitals declined over the study period. Furthermore, patients with these infections experienced lower hospital mortality and shorter hospital LOS. Copyright (C) 2014 by the Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.