Effect of an External Urinary Collection Device on Catheter Associated Urinary Tract Infections in Hospitalized Women

Mentor: Mark Rupp Program: Internal Medicine, Division of Infectious Disease Type: Original Research Background: Catheter-associated urinary tract infections (CAUTIs) are a common hospital acquired infection (HAI) resulting in excess morbidity, mortality, and cost. A female external urine collection device (EUCD) was implemented in our facility in efforts to decrease catheter days and limit CAUTI. Methods: Retrospective, 32 month, quasi-experimental, pre:post study comparing 14 months before and after EUCD introduction with a three month introduction period. Results: The overall CAUTI rate per 1000 patient days (PD) decreased slightly from 0.24 to 0.20 (P=0.44; model risk 0.86 (95% CI 0.58–1.26), while the rate per 1000 catheter days (CD) increased slightly 1.5 to 1.6 (P=0.76; model risk 1.06 (95% CI 0.73–1.56). The CAUTI rate for men increased from 0.09 to 0.11 (P=0.42) and from 0.99 to 1.55 (P=0.17); per 1000 PD and 1000 CD, with a model predicted risk of 1.29 and 1.56 respectively. For women, the rate of CAUTI decreased from 0.15 to 0.09 (P=0.10) and from 2.12 to 1.65 (P=0.38) per 1000 PD and 1000 CD, with a model predicted risk of 0.61 and 0.38 respectively. A significant (P<0.0001) decrease in catheter days (CD per 1000 PD) was observed for all hospitalized patients (158.56 to 128.3); men (87.06 to 72.15); women (71.49 to 56.15) with model predicted risk of 0.81, 0.83, and 0.79 respectively. Conclusion: Introduction of an EUCD for women was associated with a significantly decreased indwelling catheter usage and a trend (P=0.10) toward decreased CAUTI’s per 1000 pt d for women. Additional studies on EUCD association with UTI (both CAUTI and non-catheter UTI) are warranted.