Journal of the Chinese Medical Association
Volume 70, Issue 6 , Pages 236-240, June 2007

Impact of Urinary Catheterization on Geriatric Inpatients with Community-acquired Urinary Tract Infections

  • Shih-Chao Kang

      Affiliations

    • Division of Family Medicine, Executive Yuan, Taiwan, R.O.C.
    • Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.
    • ,
  • Nai-Wei Hsu

      Affiliations

    • Department of Internal Medicine, Executive Yuan, Taiwan, R.O.C.
    • National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • ,
  • Gau-Jun Tang

      Affiliations

    • Superintendent's Office, I-Lan Hospital, Department of Health, Executive Yuan, Taiwan, R.O.C.
    • National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • Corresponding Author InformationCorrespondence to: Dr Gau-Jun Tang, Superintendent's Office, I-Lan Hospital, Department of Health, Executive Yuan, 152, Xin-Min Road, I-Lan City, I-Lan 260, Taiwan, R.O.C.
    • ,
  • Shinn-Jang Hwang

      Affiliations

    • Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.
    • National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.

Received 21 July 2006; accepted 22 May 2007.

Article Outline

Background

Urinary tract infections commonly cause hospitalizations in community-dwelling geriatric populations. Our aim was to understand the impact of urinary catheterization on geriatric inpatients with community-acquired urinary tract infections (CAUTIs).

Methods

Retrospective analyses were performed using electronic discharge summaries in a rural community hospital of northeastern Taiwan in 2004. We screened data with ICD-9-CM codes and performed chart reviews on inpatients aged ≥65 years with CAUTIs.

Results

A total of 294 subjects who experienced CAUTIs were enrolled; 114 subjects had urinary catheterization and the other 180 did not. The mean frequency of admission was 1.2 times (range, 1-4 times); 251 subjects were admitted only once. We reviewed and enrolled 348 records of CAUTIs. Subjects with urinary catheterization showed significantly more advanced age, more female predominance, higher immobility ratio, and more frequent admissions than those without urinary catheterization (p<0.05). Records of urinary catheterization showed that subjects had longer hospital stays, higher pathogen isolation after culture, and less comorbid pyelonephritis than subjects without urinary catheterization (p<0.05). The distribution of infecting microorganisms differed insignificantly between the 2 groups (p = 0.077). Female gender, hospitalization > 2 times, age ≥75 years, immobility, hospital stay > 7 days, and low prevalence of comorbid pyelonephritis served as significant predictive variables for urinary catheterization in subjects with CAUTIs.

Conclusion

For geriatric inpatients, urinary catheterization must be evaluated cautiously before being performed. The impact of urinary catheterization on the distribution of microorganisms in CAUTIs was shown to be insignificant.

Key Words:  community-acquired infections , geriatrics , urinary catheterization , urinary tract infections

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PII: S1726-4901(09)70365-X

doi:10.1016/S1726-4901(09)70365-X

Journal of the Chinese Medical Association
Volume 70, Issue 6 , Pages 236-240, June 2007

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