Impact of urinary catheterization on geriatric inpatients with community-acquired urinary tract infections.

BACKGROUND Urinary tract infections commonly cause hospitalizations in community-dwelling geriatric populations. Our aim was to understand the impact of urinary catheterization on geriatric inpatients with community-acquired urinary tract infections (CAUTIs). METHODS Retrospective analyses were performed using electronic discharge summaries in a rural community hospital of northeastern Taiwan in 2004. We screened data with ICD-9-CM codes and performed chart reviews on inpatients aged >or= 65 years with CAUTIs. RESULTS A total of 294 subjects who experienced CAUTIs were enrolled; 114 subjects had urinary catheterization and the other 180 did not. The mean frequency of admission was 1.2 times (range, 1-4 times); 251 subjects were admitted only once. We reviewed and enrolled 348 records of CAUTIs. Subjects with urinary catheterization showed significantly more advanced age, more female predominance, higher immobility ratio, and more frequent admissions than those without urinary catheterization (p < 0.05). Records of urinary catheterization showed that subjects had longer hospital stays, higher pathogen isolation after culture, and less comorbid pyelonephritis than subjects without urinary catheterization (p < 0.05). The distribution of infecting microorganisms differed insignificantly between the 2 groups (p = 0.077). Female gender, hospitalization > 2 times, age >or=75 years, immobility, hospital stay > 7 days, and low prevalence of comorbid pyelonephritis served as significant predictive variables for urinary catheterization in subjects with CAUTIs. CONCLUSION For geriatric inpatients, urinary catheterization must be evaluated cautiously before being performed. The impact of urinary catheterization on the distribution of microorganisms in CAUTIs was shown to be insignificant.