Incidence of urinary tract infections in patients with permanent percutaneous nephrostomy after implementation of a standardized care program.

Abstract

Introduction: Percutaneous nephrostomy tubes (PNT), which are used in some cancer hospitals, are associated with an increase in urinary tract infections (UTI).

Objective: To determine the impact of a standardized care program on the incidence of UTIs requiring hospitalization (UTI-RH).

Material and methods: Retrospective study that included patients with a first PNT inserted. The incidence, relative risk (RR), costs and outcomes of patients with UTI-RH were compared during the period before (P0) vs. after the intervention (P1).

Results: 113 PNTs were inserted during P0, and 74 at P1. During P0, 61 patients (53.9%) experienced 64 UTI-RH events in 22,557 PNT days. At P1, four patients (5.4%) had a UTI-RH in 6,548 PNT days (IRR: 0.21, 95% CI: 0.05-0.57). The RR was 0.09 (95% CI: 0.03-0.25). Monthly cost per day/bed was USD 3,823 at P0 and USD 1,076 at P1, and for antibiotics, it was USD 790 at P0 and USD 123.5 at P1.

Conclusions: This study highlights the importance of a standardized care program for permanent percutaneous devices, since this reduces antibiotic use, hospitalization, and the cost of care.