The Impact of Catheter-Associated Urinary Tract Infection (CA-UTI) in Critically Ill Children in the Pediatric Intensive Care Unit

Abstract Objective Catheter-associated urinary tract infections (CA-UTIs) comprise a significant proportion of hospital-acquired infections. However, the impact of CA-UTIs on important outcome measures, such as length of stay (LOS) and hospital charges, has not been examined in the pediatric intensive care unit (PICU) setting. Design Single-center, retrospective, case-matched, cohort study and financial analysis. Setting PICU in a tertiary-care children's medical center. Patients A total of 41 critically ill children with CA-UTIs and 73 critically ill children without CA-UTI, matched for age, gender, severity of illness, and primary admission diagnosis. Interventions None. Measurements and Main Results We compared the length of hospital stay (LOS in PICU and in hospital), mortality, and hospital costs in critically ill children with CA-UTIs and their matched controls. Critically ill children experiencing CA-UTI had significantly longer PICU LOS, hospital LOS, duration of mechanical ventilation, and mortality compared with matched controls without CA-UTI. The longer LOS resulted in higher PICU and hospital charges in this group. Conclusion Critically ill children with CA-UTI experience worse outcomes in the PICU compared with those without CA-UTI. Further studies on the impact of CA-UTI in the PICU are warranted.