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NameDOBAgeM FTest PeriodUnitEvent DateMR #Account #Medicare # Pt expire Yes NoAdm dateD/C dateAdm DiagnosisAttendingUrology ConsultICU Adm dateICU D/C dateCulture datePathogen(s)CFUsCulture datePathogen(s)CFUsCath Insertion DateCath D/C DateLocation of insertionBundle orderedApproved indication for catheter documented All elements of the SUTI & ABUTI criterion must occur during the Infection Window PeriodSymptomatic Urinary Tract Infection (SUTI) 1Patient has a urine culture with no more than two species of organisms, at least one of which is a bacteria of ≥10? CFU/ml. Symptomatic Urinary Tract Infection (SUTI) 2 (Infants ≤1 year of age)Patient has a urine culture with no more than two species of organisms, at least one of which is a bacteria of ≥10? CFU/ml.One of the following: DateDate1a (cath assoc) Patient has an indwelling urinary catheter in place for the entire day on the date of event and such catheter had been in place for >2 calendar days, on that date (day of device placement = Day 1) Pt ≤1 year of age (with? or without an indwelling urinary catheter)ANDat least one of the following signs or symptoms:Fever (>38° C core)OR1a (cath assoc) Patient had an indwelling urinary catheter in place for >2 calendar days which was removed on the day of, or day before the date of eventHypothermia (<36°C core)Apnea*Bradycardia*OR1b (non-cath assoc) Patient has/had an indwelling urinary catheter but it has/had not been in place >2 calendar days, ORPatient did not have a urinary catheter in place on the date of event nor the day before the date of eventLethargy*Vomiting*Suprapubic tenderness*Notes:Fever and hypothermia are non-specific symptoms of infection and cannot be excluded from UTI determination because they are clinically deemed due to another recognized cause. “abdominal pain” or “back pain” is not specific enough to meet criteriaANDat least 1 of the following signs or symptoms:Fever (>38° C) (for 1B, pt is < 65yo)Suprapubic tenderness*Costovertebral angle pain or tenderness*Secondary BSI? Yes NoUrinary urgency* ?Frequency* ?Did patient have an order to leave foley in place? Yes NoOrdered by:Dysuria* ?Asymptomatic Bacteremic Urinary Tract Infection (ABUTI) (Patient of any age)DatePatient with? or without an indwelling urinary catheter has no signs or symptoms of SUTI 1 or 2 according to age (Note: Patients > 65 years of age with a non-catheter-associated ABUTI may have a fever and still meet the ABUTI criterion) ANDPatient has a urine culture with no more than two species of organisms, at least one of which is a bacteria of ≥10? CFU/ml ANDPatient has a positive blood culture with at least one matching bacteria to the urine culture, or meets LCBI criterion 2 (without fever) and matching common commensal(s) in the urine. ? cannot be used as symptoms when catheter is in place. ? If patient had an indwelling urinary catheter in place for >2 calendar days, and catheter was in place on the date of event or the previous day the CAUTI criterion is met. If no such indwelling urinary catheter was in place, UTI (non-catheter associated) criterion is met. *With no other recognized cause?Patient had an indwelling urinary catheter in place for >2 calendar days, with day of device placement being Day 1, and catheter was in place on the date of event or the day before. Table of EventsDateHospital DayDate of EventInfection Window PeriodRITUnitFoleyUrine CxTemp > 38Suprapubic tendernessCV angle pain/tendernessUrgencyFrequencyDysuriaBlood CxInfection Window Period (first + diagnostic test, 3 days before & 3 days after) Repeat Infection Timeframe-RIT (14 day timeframe where date of event = day 1)Date of Event (date the first element occurs for the first time within the infection window period) Secondary BSI Attribution Period (Infection Window Period + RIT) ................
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