In an effort to reduce catheter-associated urinary tract infections, hospital clinicians may be unnecessarily testing and treating patients for UTIs, according to a study published recently in Infection Control & Hospital Epidemiology.
Instead of testing patients for UTIs, hospitals should instead focus on proper insertion, maintenance and removal of indwelling catheters and follow strict criteria for testing, according to the study's authors.
"In our prevention model of CAUTI, we included guidance for which patients should be tested, excluding those without symptoms or high-risk of invasive infection," said Katherine Mullin, MD, an infectious disease clinician at Cleveland Clinic and the study's lead author. "Obviously, the success of this 'stewardship of culturing' model is reliant on adherence to best bedside practices regarding appropriate care of catheters."
The study documents how Cleveland Clinic's intensive care units implemented catheter protocols and also agreed to follow the American College of Critical Care Medicine and Infectious Disease Society of America guidelines for culturing patients to test for UTIs.
The intervention led to a decrease in CAUTIs, from 3 per 1,000 catheter days in 2013 to 1.9 in 2014. Additionally, researchers analyzed hospital-acquired bloodstream infection rates and saw it drop from 2.8 per 1,000 patient days to 2.4, meaning the reduction in testing likely didn't miss any true infections.