Catheter-Associated UTI :Once an indwelling foley catheter is in place, the risk of bacteriuria is approximately 5 percent per day. With longterm catheterization, bacteriuria is inevitable. Catheter associated urinary tract infections account for 40 percent of all nosocomial infections and are the most common source of gram-negative bacteremia in hospitalized patients.
The diagnosis of catheter-associated urinary tract infection can be made when the urine culture shows 100 or more CFU per mL of urine from a catheterized patient. The microbiology of catheter-associated urinary tract infections includes E. coli and Proteus, Enterococcus, Pseudomonas, Enterobacter, Serratia and Candida species. The bacterial distribution reflects the nosocomial origin of the infections because so many of the uropathogens are acquired exogenously via manipulation of the catheter and drainage device.
Bacteriuria is often polymicrobic, especially in patients with long-term indwelling urinary catheters. Symptomatic bacteriuria in a patient with an indwelling Foley catheter should be treated with antibiotics that cover potential nosocomial uropathogens. Patients with mild to moderate infections may be treated with one of the oral quinolones, usually for 10 to 14 days. Parenteral antibiotic therapy may be necessary in patients with severe infections or patients who are unable to tolerate oral medications. The recommended duration of therapy for severe infections is 14 to 21 days.
Treatment is not recommended for catheterized patients who have asymptomatic bacteriuria, with the following exceptions: patients who are immunosuppressed after organ transplantation, patients at risk for bacterial endocarditis and patients who are about to undergo urinary tract instrumentation.
Bacteriuria is almost inevitable with long-term catheterization, and prevention strategies have largely been unsuccessful. In such patients, catheters should be changed periodically to prevent the formation of concretions and obstruction that can lead to infection. Prophylactic systemic antibiotics have been shown to delay the onset of bacteriuria in catheterized patients, but this strategy may lead to increased bacterial resistance.
Common source of gram negative.
Septicaemia in hospitalised patients.
40% of nosocomial injections.
>100 CFU/ml of urine dianostic (CF men/women).
Polymicrobial in nature.
10-14 day therapy is warranted.
Change catheters and connections.
Prophylactic antibiotics leads to resistance. |
Comments
for urinary problem which doctor shall I contact Medicine or Urologist
I have UTI generally recurring. Last time I had around a years back and got treated with Ofloxacin for about 15 days. Today I am suffering for very frequent urination with sensation and unable to control. Kindly suggest some medicine.
First UTI in over 10 yrs. Unfortunately I've had over a month of UTI symptoms. The first two urine specimens were [ ] for blood, WBC, and bacteria but were NEVER cultured. I went through two different rounds of antibiotics. Symptoms still there. My doctors were saying obviously it isn't an UTI, that it must be stress or something else. We'll finally after suffering a month, the next urine sample WAS cultured and it came back I have coagulase negative staph. And get this, the bacteria is resistant to most antibiotics, including penicillin, Levaquin, Sulfa, and Cipro. I'm not so sure not culturing a positive urine sample is such a great idea. I know I have greatly suffered. I'm now on macrobid and hoping this will take care of it.
I have a recalled bladder sling and I have been having recurring UTI synptoms. Nitrites and leukocytes are always present, but cultures grow nothing. I am at a loss and so is my Dr. I am seeing a specialist at Vanderbilt and he is removing the sling in a couple of weeks. Anyone else have this issue?
i have found that UTIs with no symptoms should not be treated especially if they have ESBL or KPC.
A well known case ESBL to me I stoped treating her with antibiotics works now well for more than 8 months