Book contents
- Frontmatter
- Contents
- Preface
- Contributors
- Part I Clinical Syndromes – General
- Part II Clinical Syndromes – Head and Neck
- Part III Clinical Syndromes – Eye
- Part IV Clinical Syndromes – Skin and Lymph Nodes
- Part V Clinical Syndromes – Respiratory Tract
- Part VI Clinical Syndromes – Heart and Blood Vessels
- Part VII Clinical Syndromes – Gastrointestinal Tract, Liver, and Abdomen
- Part VIII Clinical Syndromes – Genitourinary Tract
- Part IX Clinical Syndromes – Musculoskeletal System
- Part X Clinical Syndromes – Neurologic System
- Part XI The Susceptible Host
- Part XII HIV
- Part XIII Nosocomial Infection
- 101 Prevention of Nosocomial Infection in Staff and Patients
- 102 Percutaneous Injury: Risks and Management
- 103 Hospital-Acquired Fever
- 104 Transfusion-Related Infection
- 105 Intravascular Catheter-Related Infections
- 106 Infections Associated with Urinary Catheters
- Part XIV Infections Related to Surgery and Trauma
- Part XV Prevention of Infection
- Part XVI Travel and Recreation
- Part XVII Bioterrorism
- Part XVIII Specific Organisms – Bacteria
- Part XIX Specific Organisms – Spirochetes
- Part XX Specific Organisms – Mycoplasma and Chlamydia
- Part XXI Specific Organisms – Rickettsia, Ehrlichia, and Anaplasma
- Part XXII Specific Organisms – Fungi
- Part XXIII Specific Organisms – Viruses
- Part XXIV Specific Organisms – Parasites
- Part XXV Antimicrobial Therapy – General Considerations
- Index
106 - Infections Associated with Urinary Catheters
from Part XIII - Nosocomial Infection
Published online by Cambridge University Press: 05 March 2013
- Frontmatter
- Contents
- Preface
- Contributors
- Part I Clinical Syndromes – General
- Part II Clinical Syndromes – Head and Neck
- Part III Clinical Syndromes – Eye
- Part IV Clinical Syndromes – Skin and Lymph Nodes
- Part V Clinical Syndromes – Respiratory Tract
- Part VI Clinical Syndromes – Heart and Blood Vessels
- Part VII Clinical Syndromes – Gastrointestinal Tract, Liver, and Abdomen
- Part VIII Clinical Syndromes – Genitourinary Tract
- Part IX Clinical Syndromes – Musculoskeletal System
- Part X Clinical Syndromes – Neurologic System
- Part XI The Susceptible Host
- Part XII HIV
- Part XIII Nosocomial Infection
- 101 Prevention of Nosocomial Infection in Staff and Patients
- 102 Percutaneous Injury: Risks and Management
- 103 Hospital-Acquired Fever
- 104 Transfusion-Related Infection
- 105 Intravascular Catheter-Related Infections
- 106 Infections Associated with Urinary Catheters
- Part XIV Infections Related to Surgery and Trauma
- Part XV Prevention of Infection
- Part XVI Travel and Recreation
- Part XVII Bioterrorism
- Part XVIII Specific Organisms – Bacteria
- Part XIX Specific Organisms – Spirochetes
- Part XX Specific Organisms – Mycoplasma and Chlamydia
- Part XXI Specific Organisms – Rickettsia, Ehrlichia, and Anaplasma
- Part XXII Specific Organisms – Fungi
- Part XXIII Specific Organisms – Viruses
- Part XXIV Specific Organisms – Parasites
- Part XXV Antimicrobial Therapy – General Considerations
- Index
Summary
Urinary tract infections (UTIs) are a common and clinically important outcome of the use of urinary catheters. Urinary catheters may be (1) short-term indwelling urethral catheters, (2) long-term indwelling urethral catheters, or (3) intermittent catheterization.
A patient has a short-term indwelling catheter when the duration of catheterization is less than 30 days and a long-term indwelling catheter when the catheter remains in situ more than 30 days. Considerations for indwelling suprapubic catheters are similar to those for indwelling urethral catheters. Different types of catheterization are indicated in different populations and have different risks for the occurrence of infection (Table 106.1).
PATHOGENESIS
Acquisition of urinary infection with catheter use is virtually always through ascending infection (Table 106.2). For indwelling urethral catheters, bacteria usually ascend into the bladder on the mucous sheath on the external surface of the catheter, up the drainage tubing in the urine column, or with bacterial biofilm on the inner surface of the tubing. Organisms colonizing the periurethral area ascending on the external surface of the catheter are a more common source of bacteriuria for women, and organisms gaining access through the tubing occurs more often in men. Disruption of the closed drainage system from the bladder to the drainage bag also may introduce bacteria, and there is a high incidence of urinary infection within 24 hours following such a break in the system. Bacteria introduced at the time of catheterization account for less than 5% of infections.
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- Clinical Infectious Disease , pp. 761 - 766Publisher: Cambridge University PressPrint publication year: 2008