Abstract: Current Patterns in Nosocomial Urinary Tract Infections

Edwin M. Meares, Jr., MD. "Current Patterns in Nosocomial Urinary Tract Infections." Supplement to Urology 37 (March 1991) 3: 9-12.

Objectives:
* To review the pathogenesis, risk factors, and consequences of nosocomial UTI (hospital-acquired urinary tract infections), to discuss preventive measures, and to offer specific guidelines for catheter management.

Conclusions:
* "Nosocomial infections develop in about five percent of patients admitted to acute care hospitals in the United States. The genitourinary tract is the primary site of infection in about 40 percent of cases, and urinary tract instrumentations and catheterization are implicated in about eighty percent of genitourinary tract nosocomial infections."
* "Catheter-associated urinary tract infections are a frequent source of serious patient morbidity, urosepsis, and even death."
* Females, the elderly, those with a critical and debilitating illness, diabetics, those with defective immune systems, the malnourished, the neutropenic, those whose immune systems are compromised as a result of illness or therapeutic regimens, and those who are hospitalized for extended stays are all at high risk for nosocomial UTI.
* "The patient's own fecal flora is the main source of bacterial pathogens that cause nosocomial UTIs." An uninfected patient can also acquire UTI from an infected patient if hospital personnel fail to wash their hands thoroughly between emptying the patients' urinary drainage bags.
* "Because urethral catheterization is associated with significant morbidity and even mortality, the indications for catheterization must be sound and aseptic techniques used."

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