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Bladder Management and Urinary Tract Infections in Danish Hospitals, Nursing Homes, and Home Care: A National Prevalence Study

Published online by Cambridge University Press:  02 January 2015

Jette Zimakoff ,
David J. Stickler ,
Birgitte Pontoppidan  and
Severin O. Larsen
Jette Zimakoff
Affiliation:
National Centre for Hospital Hygiene, Copenhagen S, Denmark
David J. Stickler*
Affiliation:
School of Pure and Applied Biology, University of Wales College of Cardiff, Cardiff, Wales, United Kingdom
Birgitte Pontoppidan
Affiliation:
National Centre for Hospital Hygiene, Copenhagen S, Denmark
Severin O. Larsen
Affiliation:
Biostatistical Department, Statens Seruminstitut, Copenhagen S, Denmark
*
National Centre for Hospital Hygiene, Statens Seruminstitut, Artillerivej 5, DK 2300, Copenhagen S, Denmark
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Abstract

Objective:

To establish the prevalence of urinary tract infection in patients undergoing various forms of bladder management.

Design:

A nationwide descriptive point-prevalence survey with logistic regression analysis of the data relating infection to bladder management.

Setting:

Fifteen hospitals, 21 nursing homes, and 13 home care districts throughout Denmark.

Patients:

Information was collected on 3,665 patients. On the day of the study, 349 patients had indwelling catheters and 1,150 were using external urine drainage systems (condoms or diapers) for bladder management.

Results:

The prevalence of urinary tract infections in catheterized patients and those using external drainage systems was 13.2% and 8.1%, respectively. The prevalence of hospital-acquired urinary tract infection (4.2%) had not changed from that reported in 1978. The proportion of these infections related to the indwelling catheter, however, had reduced from 66% to 30%. Logistic regression analysis confirmed that, when corrected for the patient-related confounders (female gender, age >60 years, incontinence, immobility, and stay in hospital for longer than 15 days), condoms (odds ratio [OR], 5.94; 95% confidence interval [CI95], 2.8 to 12.5), indwelling catheters (OR, 3.3; CI95, 2.3 to 4.8), and diapers (OR, 1.5; CI95, 1.1 to 2.1) were significantly (P<.001, P<.001, and P=.008, respectively) related to infection.

Conclusions:

Prevalence surveys have revealed that over the period 1978 to 1991, during which efforts have been made to restrict the use of indwelling catheters and to encourage the care of catheterized patients according to guidelines recommended by the Danish National Centre for Hospital Hygiene, the percentage of hospital-acquired urinary tract infections associated with indwelling catheters has been halved. External urine drainage systems, however, have emerged as significant risk factors for urinary tract infection.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 17 , Issue 4 , April 1996 , pp. 215 - 221
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1996 

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