A before–after prospective active surveillance study was carried out to determine rates of
CAUTI in 1506 ICU patients, hospitalized during 10 291 bed-days. The study period was divided into two
phases: phase 1 (baseline) and phase 2 (intervention). During phase 1, surveillance was performed
applying the definitions of the US Centers for Disease Control and Prevention National Healthcare Safety
Network (CDC/NHSN). In phase 2, we adopted a multidimensional approach that included: (1) a bundle
of infection control interventions, (2) education, (3) surveillance of CAUTI rates, (4) feedback on CAUTI
rates,(5) process surveillance, and (6) performance feedback. We used random effects Poisson regression
to account for clustering of CAUTI rates across time-periods.
Results: We recorded a total of 9829 urinary catheter-days: 306 in phase 1 and 9523 in phase 2. The rate
of CAUTI was 13.07 per 1000 urinary catheter-days in phase 1, and was decreased by 83% in phase 2 to
2.21 per 1000 urinary catheter-days (risk ratio 0.17; 95% confidence interval 0.06–0.5; p = 0.0002).
Conclu