Prevalence, incidence, and risk factors of urinary tract infection among immobile inpatients in China: a prospective, multi-centre study

Background: Immobile inpatients have a high risk of urinary tract infection (UTI). Additional epidemiological data regarding UTIs among immobile inpatients are needed. Aim: To investigate the prevalence and incidence of, and risk factors for, UTIs among immobile patients in 25 hospitals throughout China. Methods: This was a national multi-centre cross-sectional investigation. We recruited six tertiary hospitals, 12 non-tertiary hospitals, and seven community hospitals. We obtained data regarding demographics, clinically related variables, and UTI-specific variables from immobile patients during their hospitalization. We performed univariate and multivariable analyses, and binary logistic regression analysis was used to identify risk factors. Findings: Among 23,985 immobile patients, 393 had a UTI. The prevalence and incidence of UTIs in hospitalized immobile patients was 1.64% (393/23 985) and 0.69 per 1000 patient-days, respectively. The infection rate of catheter-associated UTI was 2.25 per 1000 urinary catheter-days. We found that a greater number of bedridden days, longer length of hospital stay, being in a medical ward, the presence of an indwelling urethral catheter, prolonged duration of an indwelling catheter, use of glucocorticoids, female sex, diabetes mellitus, and older age were independent risk factors of UTI. Conclusion: Immobile patients had similar risk factors for UTI as the general population, as well as some additional risk factors. Greater attention is needed in the management of UTIs among the population of immobile hospitalized patients. (C) 2019 Published by Elsevier Ltd on behalf of The Healthcare Infection Society.