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Incidence of catheter-associated urinary tract infection among dogs in a small animal intensive care unit

Sean D. Smarick VMD, DACVECC1,2, Steve C. Haskins DVM, DACVECC, DACVA3, Janet Aldrich DVM4, Janet E. Foley DVM, PhD5, Philip H. Kass DVM, PhD, DACVPM6, Mack Fudge DVM, MPVM, DACVECC7, and Gerald V. Ling DVM8
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  • 1 Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California, Davis, CA 95616.
  • | 2 Current address is Allegheny Veterinary Emergency Associates, 1810 Rte 286, Pittsburgh, PA 15239.
  • | 3 Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, CA 95616.
  • | 4 Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California, Davis, CA 95616.
  • | 5 Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, CA 95616.
  • | 6 Department of Population Health and Reproduction, School of Veterinary Medicine, University of California, Davis, CA 95616.
  • | 7 Army Medical Department Center and School, Fort Sam Houston, TX 78234.
  • | 8 Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, CA 95616.

Abstract

Objective—To determine incidence of and possible risk factors for catheter-associated urinary tract infection (UTI) among dogs hospitalized in an intensive care unit and compare results of bacterial culture of urine samples with results of bacterial culture of catheter tips.

Design—Prospective study.

Animals—39 dogs.

Procedure—A standard protocol for aseptic catheter placement and maintenance was used. Urine samples were obtained daily and submitted for bacterial culture. When possible, the urinary catheter tip was collected aseptically at the time of catheter removal and submitted for bacterial culture. Bacteria that were obtained were identified and tested for antimicrobial susceptibility.

Results—4 of the 39 (10.3%) dogs developed a UTI. The probability of remaining free from UTI after 1 day in the intensive care unit was 94.9%, and the probability of remaining free from UTI after 4 days was 63.3%. Bacteria isolates were generally common urinary tract pathogens and were susceptible to most antimicrobials. Specific risk factors for catheter-associated UTI, beyond a lack of antimicrobial administration, were not identified. Positive predictive value of bacterial culture of urinary catheter tips was only 25%.

Conclusions and Clinical Relevance—Results suggest that placement of an indwelling urinary catheter in dogs is associated with a low risk of catheter-associated UTI during the first 3 days after catheter placement, provided that adequate precautions are taken for aseptic catheter placement and maintenance. Results of bacterial culture of urinary catheter tips should not be used to predict whether dogs developed catheter-associated UTI. (J Am Vet Med Assoc 2004;224:1936–1940)

Abstract

Objective—To determine incidence of and possible risk factors for catheter-associated urinary tract infection (UTI) among dogs hospitalized in an intensive care unit and compare results of bacterial culture of urine samples with results of bacterial culture of catheter tips.

Design—Prospective study.

Animals—39 dogs.

Procedure—A standard protocol for aseptic catheter placement and maintenance was used. Urine samples were obtained daily and submitted for bacterial culture. When possible, the urinary catheter tip was collected aseptically at the time of catheter removal and submitted for bacterial culture. Bacteria that were obtained were identified and tested for antimicrobial susceptibility.

Results—4 of the 39 (10.3%) dogs developed a UTI. The probability of remaining free from UTI after 1 day in the intensive care unit was 94.9%, and the probability of remaining free from UTI after 4 days was 63.3%. Bacteria isolates were generally common urinary tract pathogens and were susceptible to most antimicrobials. Specific risk factors for catheter-associated UTI, beyond a lack of antimicrobial administration, were not identified. Positive predictive value of bacterial culture of urinary catheter tips was only 25%.

Conclusions and Clinical Relevance—Results suggest that placement of an indwelling urinary catheter in dogs is associated with a low risk of catheter-associated UTI during the first 3 days after catheter placement, provided that adequate precautions are taken for aseptic catheter placement and maintenance. Results of bacterial culture of urinary catheter tips should not be used to predict whether dogs developed catheter-associated UTI. (J Am Vet Med Assoc 2004;224:1936–1940)