Catheter-associated urinary tract infection (CAUTI) is the most common healthcare-associated infection and it has major cost implications for health services. It is a highly researched field with several new studies published every month covering prevention strategies and interventions.
A common factor in many of the studies is that indwelling catheters are identified as both the reason for and the solution to the problem. Guidelines recommend limiting the number and duration of use of indwelling catheters and often it is enough to implement reminder systems about this at hospitals and healthcare facilities. Good hygiene and alternatives to indwelling catheters (e.g. intermittent catheters) are generally recommended; this month there are at least two new reviews covering CAUTI prevention strategies.
CAUTIs are not the only complication associated with the use of indwelling urinary catheters. For example, urethral/urogenital trauma is a significant problem for some users, as demonstrated in a recent case report. This is particularly true for those living with spinal cord injury or who have decreased sensation for other reasons, as they can miss early warning signs. Using a suprapubic indwelling catheters is often an effective alternative to the traditional indwelling catheter placed through the urethra. However, a recent study indicates that suprapubic placement tends to extend catheter use, at least in the context of a group of women undergoing reconstructive pelvic surgery. This could be worth bearing in mind when considering suitable alternatives to the traditional indwelling catheter.
Indwelling Urinary Catheters: A Pathway to Health Care-Associated Infections.
https://www.ncbi.nlm.nih.gov/pubmed/28454610
Author and Origin
Clayton JL. US
Summary
Review article describing prevention of catheter-associated urinary tract infection (CAUTI).
Conclusions
CAUTI is prevented by:
1. Using aseptic technique for site preparation and supplies.
2. Limiting use and duration of the placement of urinary catheters.
Comments
Review summarizing the association between indwelling catheter use and CAUTI.
Implementing clinical guidelines to prevent catheter-associated urinary tract infections and improve catheter care in nursing homes: Systematic review.
https://www.ncbi.nlm.nih.gov/pubmed/28456320
Author and Origin
Gould D, Gaze S, Drey N, Cooper T. UK
Summary
Systematic review of the prevention of catheter-associated urinary tract infection (CAUTI) in nursing homes and long-term care.
Conclusions
CAUTI is the most common healthcare-associated infection and has cost implications for health services. Although considered avoidable, the evidence of the effectiveness of CAUTI prevention guidelines in nursing homes is scarce.
Comments
Systematic review investigating evidence of the effectiveness of CAUTI prevention guidelines in nursing homes and other long-term users of catheters.
Suprapubic versus transurethral bladder drainage following reconstructive pelvic surgery: a comparison of patient satisfaction and quality of life.
https://www.ncbi.nlm.nih.gov/pubmed/27714436
Author and Origin
Takase-Sanchez MM, Thompson JC, Hale DS, Heit MH. US
Summary
Observational prospective study comparing transurethral (TUC) or suprapubic (SPC) placement of an indwelling catheter after reconstructive pelvic surgery. The study included 178 women and reported on quality of life and patient satisfaction.
Conclusions
The study used two questionnaires for measuring quality of life related to catheter use; one was unable to verify a difference and one showed higher satisfaction with SPC. SPC gave 6 additional days of catheter use and daily antibiotic prophylaxis.
Comments
Study comparing SPC and TUC indwelling catheter use in women undergoing pelvic surgery. Reported patient satisfaction is likely to be higher with SPC, but the risks are also likely to be higher, as catheter use is extended.
Penile Erosion in a Paraplegic Man With Indwelling Urinary Catheter and Scrotal Edema.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5374753/pdf/main.pdf
Author and Origin
Young A, Mitacek R. US
Summary
Case report describing urethral trauma in a patient with spinal cord injury with a long-term urinary indwelling catheter.
Conclusions
The case is used to highlight the preventive actions that could be taken to avoid mechanical trauma to the urethra and glans penis caused by chronic catheterization. For example, intermittent catheter use is recommended.
Comments
Case report describing urethral trauma associated with long-term use of indwelling catheter in a person with spinal cord injury.
Open access.
This blog post is an extract of the Science Alert from May 2017 (76070-USX-1705)
