Historically urinary catheters have been the leading cause for nosocomial urinary tract infections (UTI).
Patient selection: adult hospitalized > 2 days
Risk factors for nosocomial UTI not related to a urinary catheter:
(1) female sex
(2) older age (age >= 40 years, aORs from 1.6 to 2.1)
(3) peptic ulcer disease (aOR 2.3)
(4) paralysis (aOR 3.1), but other reason for prolonged immobilization could contribute
(5) immunosuppression (aOR 1.5)
(6) major trauma (aOR 1.4)
(7) total parenteral nutrition (TPN, aOR 2.0)
(8) opioid therapy (aOR 1.6)
(9) urinary retention (would encompass urethral stricture)
Non-urethral devices that may contribute:
(1) suprapubic catheter
(2) nephrostomy tube
Factors reducing the risk:
(1) antibiotic therapy (aOR 0.32)
(2) anticholinergic not used for psychosis (aOR 0.68)
(3) benzodiazepines (OR 0.55)
