SHM Converge Scientific Abstract ePoster Gallery-A Comparison of the Risk of Catheter-Related Urinary Tract Infections Between Indwelling and External Urinary Devices in Hospitalized Adults

A Comparison of the Risk of Catheter-Related Urinary Tract Infections Between Indwelling and External Urinary Devices in Hospitalized Adults

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This retrospective UCSF cohort study compared hospital-acquired UTI risk in adults with indwelling urinary catheters (IUCs) versus external urinary devices from January 2021 to October 2025. Using Epic-based electronic health records and investigator chart review applying CDC/NHSN CAUTI criteria, the study excluded patients with chronic catheters, nephrostomy tubes, renal transplants, or exposure to both device types during the same hospitalization.<br /><br />The analysis included 4,768 patient encounters with IUCs and 5,396 with external devices, totaling 25,358 and 22,285 device-days, respectively. UTI incidence rates were low in both groups: 0.49 per 1,000 device-days for indwelling catheters and 0.39 per 1,000 device-days for external devices. After adjustment for age, sex, race/ethnicity, and clinical factors associated with UTI risk, there was no statistically significant difference between device types (adjusted incidence rate ratio 1.20, 95% CI 0.31–4.62; p=0.79).<br /><br />Patients with indwelling catheters were more likely to be male, have urinary retention, and receive ICU-level care, while those with external devices more often had cognitive impairment, dementia, or Parkinson’s disease. Median duration of device use was similar across groups. Overall CAUTI rates were lower than previously reported, likely due to the study’s exclusions and limited inpatient services.<br /><br />The authors concluded that external urinary devices are not necessarily safer than indwelling catheters with respect to UTI risk. Device selection should be individualized based on clinical context rather than infection risk alone, and healthcare systems may want to reconsider CAUTI surveillance policies for external devices.

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Gillian Foley

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Author List Allison Bond, Catherine Lau, Colin Hubbard, Gillian Foley, Kirsten N. Kangelaris, Margaret C. Fang, Priya A. Prasad, Sandra Oreper, Yumiko Abe-Jones

Category Research

Concept Urinary Tract Infection

Concept Catheter-Associated Urinary Tract Infection

Concept Indwelling Catheter

Concept External Urinary Device

Concept Retrospective Cohort Study

Distinguished Non-Finalist

Presenter Organization University of California, San Francisco

Presenting Author Gillian Foley

Track Outcomes Research

Keywords

catheter-associated urinary tract infection

indwelling urinary catheter

external urinary device

retrospective cohort study

UCSF

hospital-acquired UTI

CDC NHSN CAUTI criteria

device-days

incidence rate ratio

urinary device selection

Urinary Tract Infection

Catheter-Associated Urinary Tract Infection

Indwelling Catheter

External Urinary Device

Retrospective Cohort Study