Background: Urinary tract infection is one of the commonest types of healthcare-associated infections. There are currently limited data regarding the incidence and characteristics of healthcare-associated urinary tract infections (HA-UTIs) in children. This study was conducted to determine the incidence of HA-UTIs and their characteristics and associated risk factors.
Methods: A case-control study was performed from 2016 to 2020 on children under 15 years old who were diagnosed with HA-UTI. Patients who had HA-UTI were compared with non-UTI patients. The incidence rate of HA-UTIs was calculated and reported as events per 1000 patient days. Potential associated risk factors were analyzed using multivariate logistic regression.
Results: Eighty cases and 80 controls were included in the study. The incidence of HA-UTIs was 0.32 events per 1000 patient days. The median time to UTI was 18 days. The most common causative organism was Escherichia coli (43.2%) and the rates of third-generation cephalosporin resistance and carbapenem resistance were 75.6% and 4.9%, respectively. Admission longer than 7 days (OR = 21.61, 95% CI: 6.30-74.11; p < 0.001), neurogenic bladder (OR = 26.24, 95% CI: 3.77-182.87; p < 0.001), mechanical ventilation (OR = 3.60, 95% CI: 1.23-10.54; p = 0.019), and immunosuppressants (OR = 2.59; 95% CI: 1.01-6.60; p = 0.047) were the risk factors significantly associated with HA-UTIs.
Conclusions: The incidence of HA-UTIs was low in this single-center experience. Identifying patients with the risk factor is imperative for preventing the development of HA-UTIs.
Keywords: Thai; child; healthcare-associated urinary tract infection; incidence; tertiary care hospital.
© 2023 Japan Pediatric Society.