Catheter related urinary tract infection

1
Catheter related urinary tract infection

• Intern ???

2
Pathogenesis

• Extraluminal 66
• Urethral discharge
• Intraluminal 34
• Contaminant collecting bag
• Biofilm

3
Risk factors

• Duration of catheterization
• 310 bacteriuria per day
• 1025 patients have UTI symptoms
• lt 4 develop bacteremia
• Female sex
• DM
• Contamination during catheterization and drainage

4
Prevention

• Avoid unnecessary catheterization and remove
  catheter as soon as possible
• Sterile catheterization and close drainage system
• Daily meatal care does not prevent infection
• Change catheter regularly does not prevent
  infection
• Do not irrigation

5
Prevention

• Antimicrobial-coated catheter
• Suprapubic catheter
• Bacterial interference
• Epithelial coating agent
• Hyaluronic acid
• Prophylactic antibiotics no evidence

6
Choice of antibiotics

• Gram-negative bacilli
• 3rd generation of cephalosporin or
  fluoroquinolone
• Pseudomonas
• Ceftazidime or Cefepime or Ciproxin
• Enterococcus
• Ampicillin or Vancomycin
• Coagulase-negative staphylococcus
• Vancomycin

7
Treatment

• Course of antibiotics 10-14 days
• Replacement of catheter
• Remove biofilm
• Reduce bacterial load

8
Types of urethral catheters for management of
short-term voiding problems in hospitalized adults

• Silver alloy indwelling catheters reduces the
  risk of catheter acquired urinary tract
  infection. Further economic evaluation is
  required to confirm that the reduction of
  infection compensates for the increased cost of
  silver alloy catheters
• Cochrane Database of Systematic Reviews 2008