Ensuring the Epidemiological Safety of Bladder Catheterization

Abstract

Urinary tract infections (UTI) represent actual form of healthcare-associated infections. The main risk factor of UTI is bladder catheterization. Currently, there are not valid and systematic data on the frequency of atheter-associated urinary tract infections (CAUTI) in Russia, because standard case determination for the official registration is not being used and, consequently, no full-scale records and registration of this nosological form is being maintained. Research objective: to estimate incident rate and potential risk factors of UTI in patients when making bladder catheterization in the urology department at the multidisciplinary clinic for adults. In the course of diagnostic and treatment process it has been determined that bladder catheterizations ratio among all indoor patients amounted to 49,6%; in 2,3% of cases intrusive procedure was carried out urgently in the form of a single urine drainage; the overwhelming majority of catheterized patients were men – 61,5%; catheterization of 9,7% of patients has been lasted for more than 7 days; 48,5% of catheterized patients were individuals of 60 years old and over. According to retrospective analysis data with the use of standard case determination it was found out that CAUTI case rate amounted to 10,68 (95% CI 7,08–14,28) per 100 patients; stratified index of CAUTI incidence amounted to 32,86 per 1000 patient-days of catheterization (95% CI: 21,66–44,06). Epidemical process of CAUTI is characterized by high intensity, predominance of S. epidermidis. The result of the work was the development of a standard operating procedure for setting up a urethral catheter, which includes 8 stages of epidemiologically safe catheterization of the bladder. The proposed SOP on catheterization focuses on individual actions that require mandatory implementation and control.