Preventing and managing catheter-associated urinary tract infections

Abstract

Since the Foley catheter was introduced in the 1930s it has become one of the primary sources of hospital acquired infections and long term urinary catheters used in community based patients account for some 4% of community nurses’ time. This burden is likely to increase given the projected rise in life expectancy and size of the ageing population. This article considers the current literature around indwelling urinary catheterization and its management with a focus on long term catheterization in the community. The authors discuss contemporary strategies to manage or prevent CAUTI that are based on best practice guidelines. However, it is clear from the dearth of empirical evidence that there is an urgent need to establish well constructed research studies to investigate the prevalence of long term urinary catheterization in the community and the prevention and management of CAUTI.

Efficacy of urinary guidelines in the management of post‐stroke incontinence

“…As previously stated, post stroke urinary retention and the presence of indwelling catheters were found to be two predictors of post stroke UTI’s (Eldar et al , 2001; Godfrey and Frazyk, 2005; Wu and Baguley, 2005). An elevated urinary WBC is the most frequently identified predictor of UTI associated with catheter use (Madigan and Neff, 2003).…”

“…A urinary tract infection (UTI) is not an uncommon post stroke complication and is often the result of poor fluid intake, urinary retention, and/or the presence of an indwelling catheter (Dromerick and Edwards, 2003;Godfrey and Fraczyk, 2005;Wu and Baguley, 2005). One clinical parameter for diagnosing a UTI is the presence of urinary white blood cells above the normal range (Madigan and Neff, 2003).…”

Aiming to reduce catheter associated urinary tract Infections (CAUTI) by adopting a checklist and bundle to achieve sustained system improvements

“…( Apisarnthanarak et al, 2007 ;Centers for Disease Control and Prevention, 1981 ;Department of Health, 2006 ;Fryklund et al, 1997 ;Godfrey and Fraczyk, 2005 ;Gokula et al, 2004 ;Griffi ths and Fernandez, 2007 ;Hazelett et al, 2006 ;Huang et al, 2004 ). What is required now is a strategy to reduce this healthcare associated infection burden.…”

“…The urinary catheter enables micro-organisms to gain direct entry to the bladder along the external catheter surface The urinary catheter drainage system allows micro-organisms to gain entry from any of the connection points when and if they are disconnected Once micro-organisms have entered the catheter, biofi lm forms on the surface and can lead to infection and potentially to complete blockage of the catheter The risk increases the longer the catheter is in situ. ( Apisarnthanarak et al, 2007 ;Centers for Disease Control and Prevention, 1981 ;Department of Health, 2006 ;Fryklund et al, 1997 ;Godfrey and Fraczyk, 2005 ;Gokula et al, 2004 ;Griffi ths and Fernandez, 2007 ;Hazelett et al, 2006 ;Huang et al, 2004 ). What is required now is a strategy to reduce this healthcare associated infection burden.…”