A randomized trial of catheter change and short course of antibiotics for asymptomatic bacteriuria in catheterized ICU patients

Léone, Marc; Perrin, Anne-Sophie; Granier, I.; Visintini, Pierre; Blasco, V.; Antonini, François; Albanèse, Jacques; Martin, Claude

doi:10.1007/s00134-007-0534-1

Cited by 46 publications

(29 citation statements)

References 14 publications

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“…However, complications of CA-ASB in patients with short-term catheterization are rare, as shown in a large prospective cohort study of CA-bacteriuria [40]. In a prospective randomized trial in a medical-surgical ICU, 60 patients who had an indwelling urethral catheter for 148 h and developed CA-ASB were randomized to receive either a 3-day course of antimicrobials associated with the replacement of the indwelling urethral catheter or no antimicrobials and no catheter replacement [282]. There were no statistically significant differences between the 2 groups with respect to the subsequent occurrence of urosepsis or CA-bacteriuria.…”

Section: Evidence Summarymentioning

confidence: 99%

Diagnosis, Prevention, and Treatment of Catheter-Associated Urinary Tract Infection in Adults: 2009 International Clinical Practice Guidelines from the Infectious Diseases Society of America

Hooton¹,

Bradley

Cardenas

et al. 2010

Clinical Infectious Diseases

1,743

1,584

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Guidelines for the diagnosis, prevention, and management of persons with catheter-associated urinary tract infection (CA-UTI), both symptomatic and asymptomatic, were prepared by an Expert Panel of the Infectious Diseases Society of America. The evidence-based guidelines encompass diagnostic criteria, strategies to reduce the risk of CA-UTIs, strategies that have not been found to reduce the incidence of urinary infections, and management strategies for patients with catheter-associated asymptomatic bacteriuria or symptomatic urinary tract infection. These guidelines are intended for use by physicians in all medical specialties who perform direct patient care, with an emphasis on the care of patients in hospitals and long-term care facilities.

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Section: Evidence Summarymentioning

confidence: 99%

Diagnosis, Prevention, and Treatment of Catheter-Associated Urinary Tract Infection in Adults: 2009 International Clinical Practice Guidelines from the Infectious Diseases Society of America

Hooton¹,

Bradley

Cardenas

et al. 2010

Clinical Infectious Diseases

1,743

1,584

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“…2,3 Asymptomatic bacteriuria constitutes a major pool of the antibiotic-resistant strains of pathogens in any hospital, with critical care units (CCUs) 1 Final Year MBBS Student, Government Vellore Medical College and Hospital, Adukkamparai, Vellore District, Tamil Nadu, India 2 Senior Assistant Professor, 3 Professor and Head Department of Microbiology, Government Vellore Medical College and Hospital, Adukkamparai, Vellore District, Tamil Nadu, India accounting for the majority of them. 4,5 Nearly 25% of hospital patients will undergo urinary catheterization during their hospitalization and the challenges of CAUTI prevention in these patients can be difficult to overcome. 6 Although necessary in many acute care situations, inappropriate catheter use occurs in up to half of catheterized patients, the duration of catheterization remains the most significant factor in predicting CAUTI and each day of catheterization increases the risk of CAUTI by 3% to 10%.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of microorganisms causing catheter associated urinary tract infections (CAUTI) among catheterised patients admitted in a tertiary care hospital

2017

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Background: Catheter-associated urinary tract infection (CAUTI) is an important cause of morbidity and mortality in Indian subjects, affecting all age groups. Bacteriuria orcandiduria is almost inevitable in nearly half of the patients who require an indwelling urinary catheter for more than 5 days. The objective of this study was to find the prevalence of CAUTI infection and to determine their antibiotic profileMethods: The present cross-sectional study included 50 patients admitted to medicine and surgery wards in our hospital. The urine from catheter is collected from each patient and subjected to culture and antibiotic susceptibility testing.Results: The prevalence of catheter associated urinary tract infection in our hospital is about 20% and asymptomatic bacterial colonization is 50% which is nearequal to Danchaivijitr S et al study. The common pathogens found in this study are Escherichia coli (22%), Klebsiella (18%), Enterobacter (8%), Staph. aureus (6%) which include MRSA (4%), Pseudomonas (6%), Enterococcus (4%), Candida sps. (4%) Andproteus (2%).Conclusions: CAUTI has low prevalence 20% and asymptomatic colonisation 50% in our hospital with common pathogen being Escherichia coli. It is one of the important notable pathogen causing nosocomial infection among admitted patients. The patients present mainly as asymptomatic bacterial colonisation and risk of CAUTI increases with longer duration of catheterisation. All patients those who had catheter for more than 6 days, aged 60 and above, should be checked for UTI symptoms. And their urine should be cultured regularly in order to diagnose and prevent CAUTI and its complications which are very dangerous and difficult to treat.

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“…The Scottish Intercollegiate Guidelines Network, among others, has evaluated the issue thoroughly and has concluded that ASB is a benign disorder for which treatment is not indicated [14]. There have been a number of prospective randomized and nonrandomized clinical trials [15][16][17] conducted globally to determine the morbidity and mortality associated with ASB. In a study from The Netherlands, Meiland et al [18] concluded that women with type 1 or 2 diabetes and ASB did not have an increased risk for a faster decrease in renal function or the development of hypertension during 6 years of follow-up.…”

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confidence: 99%

Reducing Antibiotic Overuse: A Call for a National Performance Measure for Not Treating Asymptomatic Bacteriuria

Groß

Patel

2007

Clinical Infectious Diseases

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Positive urinary tract culture results often represent asymptomatic bacteriuria, which does not need to be treated with antimicrobial agents. Avoiding treatment of asymptomatic bacteriuria in adults should reduce the risk of development of antibiotic resistance and is consistent with the Infectious Diseases Society of America and US Preventive Services Task Force guidelines on bacteriuria. A similar approach for not treating upper respiratory illnesses with antibiotics was initiated by the Centers for Disease Control and Prevention. We propose that a hospital and ambulatory performance measure should be developed for not treating asymptomatic bacteriuria in adults. In addition, such an effort would aid hospitals in confronting the proposal of the Centers for Medicare and Medicaid Services (to be implemented in 2009) to not pay the expenses associated with catheter-associated urinary tract infection.

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A randomized trial of catheter change and short course of antibiotics for asymptomatic bacteriuria in catheterized ICU patients

Abstract: Treating a positive urine culture in an asymptomatic patient with an indwelling urethral catheter does not reduce the occurrence of urosepsis in the medico-surgical ICU.

Cited by 46 publications

References 14 publications

Diagnosis, Prevention, and Treatment of Catheter-Associated Urinary Tract Infection in Adults: 2009 International Clinical Practice Guidelines from the Infectious Diseases Society of America

Diagnosis, Prevention, and Treatment of Catheter-Associated Urinary Tract Infection in Adults: 2009 International Clinical Practice Guidelines from the Infectious Diseases Society of America

Prevalence of microorganisms causing catheter associated urinary tract infections (CAUTI) among catheterised patients admitted in a tertiary care hospital

Reducing Antibiotic Overuse: A Call for a National Performance Measure for Not Treating Asymptomatic Bacteriuria

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