Effect of a hospital-associated urinary tract infection reduction policy on general surgery patients

Background: Hospital-associated UTI rates in surgery patients have not improved despite recommendations for reducing indwelling catheter days. Methods: We performed a retrospective review of institutional NSQIP general surgery patient data, 2006–2015. During this time, a UTI-reduction policy was implemented. Demographics, HA-UTI incidence, CA-UTI incidence, indwelling catheter days, straight catheterization rates, and mortality were examined. Results: Females had significantly higher risk of HA-UTI. There was no significant change in HA-UTI (X12 = 0.02, p =.878) or indwelling catheter days (5.18 ± 1.12 days v 3.73 ± 0.39 days, p =.23). Straight catheterizations among those with HA-UTI increased (0.04 ± 0.04 v 0.32 ± 0.12, p =.029). There was no change in CA-UTI (1.38 v 1.11 CAUTI/1000 patient hospital-days P =.555) or in initial indwelling catheter days of patients with CA-UTI (7.2 SD 8.89 v 47.0 SD 7.04 days P =.961) after policy implementation. Conclusions: The reduction policy increased the number of straight catheterizations for patients developing HA-UTI, but did not reduce the number of initial indwelling catheter days, HA-UTI rates, or CA-UTI rates.