This was a cohort study conducted by hospitalacquired
infection prevention committee consisting of
one infectious disease physician who made the diagnosis
of CAUTI, a coordinator nurse who was a member
of hospital-acquired infection prevention committee, a
nurse in each participating ward and a microbiology
technician who performed urine cultures. From every
patient who was catheterized in participating wards,
a urine sample was sent for culture immediately after
catheter placement with aseptic technique after putting
on sterile gloves and disinfecting urethral meatus with
bethadine solution and using sterile drapes. If in the
next day the report were negative he/she was enrolled
to the study and at 3rd, 5th and 10th day urinalysis
was done to detect pyuria and/or nitrite by the
same nurse in each ward. Urine culture was taken
from all catheterized patients at the time of removal of
indwelling catheter or on discharge of the patient from
hospital regardless of receiving antimicrobial agents to
detect UTI. Performing urine culture was supervised
by the same lab technician.
Primary outcome to be measured was positive
urine culture. An asymptomatic catheter-associated
UTI (CAUTI) was defined as a patient whose urine
culture immediately after catheterization was negative
and his/her subsequent urine culture after removal of
catheter became positive. A urine culture was defined
as positive when it grew at least 10 (5) colony forming
units/mL with pyuria (i.e. >5WBC/HPF of sediment of
centrifuged urine) or without it. Colony count less than
10 (5)/mL was considered as asymptomatic bacteriuria
only if it were associated with pyuria, otherwise it
was considered as contamination. Mixed growth of
urine was considered contamination and excluded from
analysis if it were not associated with pyuria.