Risk Factors for Bacteremia in Patients With Urinary Catheter-Associated Bacteriuria.

The data were retrospective, so coding of comorbid conditions and specimen collection may have been incomplete or incorrect. Catheter data came from records completed by nurses, and only patients with recorded placement and removal dates were included; missed removal dates could underrepresent patients whose catheters were removed. Catheter type, placement method, placement location, catheter care procedures, and catheterization before admission were not available. Severity of illness at the time of the positive urine culture was not controlled, so patients who kept catheters may have been sicker. Chronic catheterization was not identified, so it may have affected the association between a catheter left in place and bacteremia. Controls were selected from patients without positive blood cultures, so some may have had sepsis but negative or missing cultures. A urinary tract procedure was coded at any time during admission, so it may have occurred after the relevant period. Unmeasured factors such as smoking, genetic predisposition, or blood transfusion history may have confounded the results. The study used two hospitals in one academic medical system, so results may not apply to small or rural hospitals.

The supplied text does not report author conflicts of interest. The publication types list NIH extramural research support.

Do not conclude that removing the catheter after a positive urine culture prevents bloodstream infection. This was an observational case-control study, and patients who kept catheters may have been sicker or had chronic catheters, so the association may reflect illness severity rather than the catheter itself.