Cluster analysis identifies patients at risk of catheter- associated urinary tract infections in intensive care units: findings from the SPIN-UTI Network

Barchitta, M.; Maugeri, A.; Favara, G.; Riela, P. M.; La Mastra, C.; La Rosa, M. C.; Magnano San Lio, R.; Gallo, G.; Mura, I; Agodi, A.; on behalf of the SPIN-UTI Network,; D'Errico, Marcello Mario; Donati, Abele

doi:10.1016/j.jhin.2020.09.030

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 com- munity. 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; P1⁄40.033). 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.

Titolo:	Cluster analysis identifies patients at risk of catheter- associated urinary tract infections in intensive care units: findings from the SPIN-UTI Network
Autori:	M. Barchitta A. Maugeri G. Favara P. M. Riela C. La Mastra M. C. La Rosa R. Magnano San Lio G. Gallo I Mura A. Agodi on behalf of the SPIN-UTI Network D'ERRICO, Marcello Mario [Membro del Collaboration Group] DONATI, Abele [Membro del Collaboration Group] mostra contributor esterni nascondi contributor esterni
Data di pubblicazione:	2021
Rivista:	THE JOURNAL OF HOSPITAL INFECTION
Abstract:	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 com- munity. 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; P1⁄40.033). 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.
Handle:	http://hdl.handle.net/11566/286202
Appare nelle tipologie:	1.1 Articolo in rivista

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