Abstract: Preventing Catheter-Related Bacteriuria

Sanjay Saint, MD, MPH and Benjamin A. Lipsky, MD. "Preventing Catheter-Related Bacteriuria: Should We? Can We? How?" Archives of Internal Medicine 159 (26 April 1999): 800-808.

Objectives:
* The authors review and synthesize previously published literature on the prevention of catheter-associated urinary tract infections, in order to provide clinicians with an overview of the advances made in the past two decades, and to indicate where further research is needed.

Conclusions:
* Up to 25% of hospitalized patients experience urinary catheterization during their stay. The average rate of urinary tract infection among these patients is 5% per day. "Thus, after a month of catheterization, nearly all will be bacteriuric. . . ."
* "Patients who develop a nosocomial UTI have their hospital stay extended by approximately 3 days and are nearly 3 times more likely to die during hospitalization than patients without such an infection."
* "The most important risk factor for bacteriuria is the duration of catheterization."
* The use of indwelling urinary catheters is often inappropriate. "Because up to 80% of patients with a nosocomial UTI have an indwelling urinary catheter, the best prevention strategy would be to avoid catheterization." A recent study found that "patients had an indwelling catheter for unjustified purposes for 41% of patient-days in a medical intensive care unit."
* Based upon their review of the literature concerning UTI, the authors offer a number of recommendations for preventing or minimizing the risk of bacteriuria. First and foremost, they advocate: "Avoid using a urinary catheter whenever possible. When catheterization is necessary, remove the device as soon as possible."

If you would like to read this study, please contact us and we will send a copy to you.