Urinary infections associated with lower urinary tract catheters—from evidence to alternatives

Sofronievska, Maja (2020) Urinary infections associated with lower urinary tract catheters—from evidence to alternatives. In: Urolithiasis. ENIUS. European Network of multidisciplinary research to Improve the Urinary Stents. COSTS Actions. CA16217. European Cooperation in Science & Technology, 48:553 (5). Springer, Urolithiasis (2020), pp. 553-559.

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Abstract

Lower urinary tract catheters most commonly cause urinary tract infection that occurs while a patient has an indwelling urinary catheter or within 48 h of its removal. These infections represents the largest institutional reservoir of nosocomial antibiotic-resistant pathogens such as Escherichia coli multidrug-resistant Enterobacteriaceae (Klebsiella, Enterobacter, Proteus, and Citrobacter), Pseudomonas aeruginosa, enterococci and staphylococci and Candida spp. Technological innovations have been proposed and evaluated during the past 25 years but have not proven conclusively beneficial. Among these innovations are: the use of anti-infective lubricants when inserting the catheter, soaking the catheter in an anti-infective antimicrobial-drug solution before insertion, regular metal cleansing or periodically applying anti-infective creams or ointments to metals, continuously irrigating the catheterized bladder with an anti-infective solution through a triple-lumen catheter, or periodically instilling an anti-infective solution into the collection bag. Bladder irrigation with antimicrobial-drug solutions has not only shown no benefit for prevention but has been associated with a strikingly increased proportion of UTIs caused by microorganisms resistant to the drugs in the irrigating solution. Present evidence in the literature regarding catheter materials indicates that there is no significant difference between antimicrobial catheter materials versus standard materials for short-term catheterization. There is no clear benefit among standard materials on infection rates including: latex, hydrogel-coated latex, silicone-coated latex, or all-silicone catheters. The evidence suggests that there are alternatives, such as condom catheters which reduce associated UTIs and increase patient comfort. Novel technologies must be designed to block catheter associated urinary infections by either the extraluminal or intraluminal routes or both.

Item Type:	Book Section
Subjects:	Medical and Health Sciences > Basic medicine Medical and Health Sciences > Clinical medicine Medical and Health Sciences > Health sciences Medical and Health Sciences > Other medical sciences
Divisions:	Faculty of Medical Science
Depositing User:	Maja Sofronievska
Date Deposited:	16 Aug 2022 10:58
Last Modified:	16 Aug 2022 10:58
URI:	https://eprints.ugd.edu.mk/id/eprint/29992

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