TY - JOUR
T1 - Cluster analysis identifies patients at risk of catheter-associated urinary tract infections in intensive care units
T2 - findings from the SPIN-UTI Network
AU - SPIN-UTI Network
AU - Barchitta, M.
AU - Maugeri, A.
AU - Favara, G.
AU - Riela, P. M.
AU - La Mastra, C.
AU - La Rosa, M. C.
AU - Magnano San Lio, R.
AU - Gallo, G.
AU - Mura, I.
AU - Agodi, A.
AU - Salesia, Fenaroli
AU - Ennio, Sicoli
AU - Montagna, Maria Teresa
AU - Squeri, Raffaele
AU - Di Bartolo, Rosario Massimo
AU - Salvatore, Tribastoni
AU - Mattaliano, Anna Rita
AU - Bellocchi, Patrizia
AU - Castiglione, Giacomo
AU - Astuto, Marinella
AU - Longhitano, Anna Maria
AU - Monea, Maria Concetta
AU - Scrofani, Giorgio
AU - Di Benedetto, Antonino
AU - Carmela, Riggio Maria
AU - Manta, Giuseppe
AU - Tetamo, Romano
AU - Dei, Ignazio
AU - Pandiani, Irene
AU - Antonino, Cannistrà
AU - Piotti, Paola
AU - Girardis, Massimo
AU - Righi, Elena
AU - Pierangelo, Sarchi
AU - Arnoldo, Luca
AU - Brusaferro, Silvio
AU - Coniglio, Salvatore
AU - Albino, Borracino
AU - Pintaudi, Sergio
AU - Minerva, Massimo
AU - Milazzo, Marina
AU - Bissolo, Emanuela
AU - Rigo, Alberto
AU - Fabiani, Leila
AU - Marinangeli, Franco
AU - Stefanini, Paolo
AU - D'Errico, Marcello Mario
AU - Donati, Abele
AU - Tardivo, Stefano
AU - Moretti, Francesca
N1 - Publisher Copyright:
© 2020 The Authors
PY - 2021/1
Y1 - 2021/1
N2 - Background: Although preventive strategies have been proposed against catheter-associated urinary tract infections (CAUTIs) in intensive care units (ICUs), more efforts are needed to control the incidence rate. Aim: To distinguish patients according to their characteristics at ICU admission, and to identify clusters of patients at higher risk for CAUTIs. Methods: A two-step cluster analysis was conducted on 9656 patients from the Italian Nosocomial Infections Surveillance in Intensive Care Units project. Findings: Three clusters of patients were identified. Type of admission, patient origin and administration of antibiotics had the greatest weight on the clustering model. Cluster 1 comprised more patients with a medical type of ICU admission who came from the community. Cluster 2 comprised patients who were more likely to come from other wards/hospitals, and to report administration of antibiotics 48 h before or after ICU admission. Cluster 3 was similar to Cluster 2 but was characterized by a lower percentage of patients with administration of antibiotics 48 h before or after ICU admission. Patients in Clusters 1 and 2 had a longer duration of urinary catheterization [median 7 days, interquartile range (IQR) 12 days for Cluster 1; median 7 days, IQR 11 days for Cluster 2] than patients in Cluster 3 (median 6 days, IQR 8 days; P<0.001). Interestingly, patients in Cluster 1 had a higher incidence of CAUTIs (3.5 per 100 patients) compared with patients in the other two clusters (2.5 per 100 patients in both clusters; P=0.033). Conclusion: To the authors' knowledge, this is the first study to use cluster analysis to identify patients at higher risk of CAUTIs who could gain greater benefit from preventive strategies.
AB - Background: Although preventive strategies have been proposed against catheter-associated urinary tract infections (CAUTIs) in intensive care units (ICUs), more efforts are needed to control the incidence rate. Aim: To distinguish patients according to their characteristics at ICU admission, and to identify clusters of patients at higher risk for CAUTIs. Methods: A two-step cluster analysis was conducted on 9656 patients from the Italian Nosocomial Infections Surveillance in Intensive Care Units project. Findings: Three clusters of patients were identified. Type of admission, patient origin and administration of antibiotics had the greatest weight on the clustering model. Cluster 1 comprised more patients with a medical type of ICU admission who came from the community. Cluster 2 comprised patients who were more likely to come from other wards/hospitals, and to report administration of antibiotics 48 h before or after ICU admission. Cluster 3 was similar to Cluster 2 but was characterized by a lower percentage of patients with administration of antibiotics 48 h before or after ICU admission. Patients in Clusters 1 and 2 had a longer duration of urinary catheterization [median 7 days, interquartile range (IQR) 12 days for Cluster 1; median 7 days, IQR 11 days for Cluster 2] than patients in Cluster 3 (median 6 days, IQR 8 days; P<0.001). Interestingly, patients in Cluster 1 had a higher incidence of CAUTIs (3.5 per 100 patients) compared with patients in the other two clusters (2.5 per 100 patients in both clusters; P=0.033). Conclusion: To the authors' knowledge, this is the first study to use cluster analysis to identify patients at higher risk of CAUTIs who could gain greater benefit from preventive strategies.
KW - Catheter-associated urinary tract infection
KW - Cluster analysis
KW - Intensive care unit
KW - Risk factor
KW - Sepsis
UR - http://www.scopus.com/inward/record.url?scp=85097250249&partnerID=8YFLogxK
U2 - 10.1016/j.jhin.2020.09.030
DO - 10.1016/j.jhin.2020.09.030
M3 - Article
C2 - 33017617
AN - SCOPUS:85097250249
SN - 0195-6701
VL - 107
SP - 57
EP - 63
JO - Journal of Hospital Infection
JF - Journal of Hospital Infection
ER -