Study of factors influencing the encrustation of indwelling catheters: prospective case series

Abstract

Background Long-term catheterisation is frequently necessary for patients with retention of urine or intractable incontinence who are unfit for definitive treatment or being evaluated for definitive treatment. In this study, the important factors influencing the encrustation of indwelling catheters are analysed. Methods A total of 52 patients on catheter drainage for a period ranging from 1 month to 1 year were taken in the study. Patients reported either for problems like catheter block or routine changing of catheter. The catheters were removed, and encrustation was subjected to chemical analysis. Urine was examined for pH, specific gravity, culture sensitivity and appearance. Blood samples were taken for estimation of calcium, phosphorus and uric acid. Results Out of 52 patients, 28 with urea splitting and 15 with non-urea splitting had positive urine culture (43 out of 52). Amongst 28, 27 (96%) had encrustation compared to 10 (50%) out of 15 with non-urea splitting bacteria (p value < .05). Amongst 24 patients having pH > 6, 22 (92%) had encrustation (p value < .05). The encrustation was found to be more common in bedridden patients (91%) when compared to physically active patients (54%) (p value < .05). The encrustation was more common in patients having single catheter for more than 15 days (86%) when compared to patients having catheter for shorter period (43%) (p value < .05). Conclusion This study showed definitive influence of the following factors in encrustation formation: infection with urea splitting organism, alkaline pH, physical activity of patient and duration of keeping a particular catheter.