Clinical profiles and modifiable risk factors for catheter-associated urinary tract infections in hospitalized obstetrics and gynecology patients: a case-control study

Catheter-associated urinary tract infections (CAUTIs) impose significant clinical and economic burdens on healthcare systems globally. Patients in obstetrics and gynecology face unique vulnerabilities; however, population-specific risk factors and prevention strategies remain inadequately studied from a public health perspective. This study aimed to identify clinical profiles and modifiable risk factors for CAUTIs in hospitalized obstetrics and gynecology patients, thereby informing evidence-based CAUTI prevention strategies. A retrospective case-control study was conducted among inpatients at the Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China, from November 2021 to February 2024. The case group comprised all consecutive eligible patients (n = 131) with symptomatic CAUTIs. Controls (n = 131) were matched to cases at a 1:1 ratio based on hospitalization period, primary diagnosis, treatment type, and age (± 5 years). Multivariate logistic regression analyses were performed to identify independent risk factors. Multivariate analysis of 262 obstetrics and gynecology inpatients identified four modifiable risk factors for CAUTIs, including being nutritionally at-risk upon admission (OR = 4.189, 95% CI: 1.402 ~ 12.513, P = 0.010), discharge with an indwelling urinary catheter (OR = 5.526, 95% CI: 2.352 ~ 12.985, P < 0.001), multiple catheterizations (≥ 2) (OR = 16.642, 95% CI: 2.057 ~ 134.617, P = 0.008), and a hospital stay exceeding 7 days (OR = 2.547, 95% CI: 1.423 ~ 4.560, P = 0.002). Fever was the predominant clinical symptom (85.5%), and Escherichia coli was identified as the primary pathogen (59.4%). Targeted public health interventions should prioritize nutritional screening, catheter minimization protocols, standardized discharge planning for catheterized patients, and the reduction of prolonged hospitalizations. Healthcare policy must integrate these evidence-based strategies to mitigate the burden of CAUTIs in women’s health settings.