• M Medina, G Martínez-Gallego, M Sillero-Arenas, and M Delgado-Rodríguez.
• Servicio de Cirugía General, Hospital General Ciudad de Jaén.
• Enferm. Infecc. Microbiol. Clin. 1997 Jun 1; 15 (6): 310-4.

BackgroundUrinary tract infection (UTI) is the second frequent site of infection in surgical patients; nevertheless, its study has been frequently neglected. The main objective of this report is the analysis of risk factors for ITU in general surgery.MethodsA prospective study on 1,483 patients admitted at a service of general surgery for a 20-month study period has been carried out. The criteria used for diagnosing nosocomial were those of the CDC. Crude and adjusted for by logistic regression relative risks and its 95% confidence interval were estimated. To assess the length of stay attributable to UTI, infected patients were 1:1 matched with non-infected patients for surgical procedure, ASA score, age (+/- 10 years), emergency surgery, pre-operative stay, and urinary catheter.Results33 patients (2.2%) developed UTI. In crude analysis, UTI risk was significantly associated with urethral catheter (and its duration), advanced age, severity of illness (McCabe-Jackson scale, ASA score, number of diagnoses), type of surgical wound, intrinsic risk of infection (measured by the SENIC and NNIS indices). Stepwise logistic regression analysis selected three independent predictors: urethral catheter, age and pre-operative stay. All urinary drain-ages were open. UTI prolonged hospital stay 4.7 days (95% Cl 3.4-6.2). The use of closed drain-age systems would eliminate 6 UTIs. Assuming a cost per day of hospital stay of $250 the use of closed systems would save $7,000 (IC 95%, 5300-9300).ConclusionThe use of closed systems for urethral catheters is cost-saving.

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