Hostname: page-component-586b7cd67f-2plfb Total loading time: 0 Render date: 2024-11-30T20:22:09.906Z Has data issue: false hasContentIssue false
  • English
  • Français

Effect of Bacteriologic Monitoring of Urinary Catheters on Recognition and Treatment of Hospital-Acquired Urinary Tract Infections

Published online by Cambridge University Press:  02 January 2015

Jay A. Jacobson ,
John P. Burke  and
Evelyn Kasworm
Jay A. Jacobson*
Affiliation:
Division of Infectious Diseases, LDS Hospital and University of Utah College of Medicine, Salt Lake City, Utah
John P. Burke
Affiliation:
Division of Infectious Diseases, LDS Hospital and University of Utah College of Medicine, Salt Lake City, Utah
Evelyn Kasworm
Affiliation:
Division of Infectious Diseases, LDS Hospital and University of Utah College of Medicine, Salt Lake City, Utah
*
Division of Infectious Diseases, LDS Hospital, 325 Eighth Ave., Salt Lake City, UT 84143
Get access Rights & Permissions [Opens in a new window]

Abstract

Catheter-associated urinary tract infections remain the most common hospital-acquired infection. Regular bacteriologie monitoring of urine from catheterized patients has been advocated as a measure for reducing the morbidity associated with this infection. To assess the effectiveness of this measure we reviewed the records of 100 catheterized patients hospitalized before implementation of a monitoring program and 200 such patients admitted after a daily monitoring program was operational. We found that culturing urine from catheterized patients was infrequent prior to monitoring but, when done, patients usually were febrile, cultures usually were positive, and patients were treated. Monitoring identified more cases of bacteriuria, but less than half of the patients so identified were treated. Being febrile was associated with receiving antibiotics. Infection rates increased with duration of catheterization; long periods of catheterization typically occurred on the neurosurgical, orthopedic, and medical services. Daily bacteriologie monitoring of all catheterized patients is relatively inefficient and does not predictably lead to therapeutic intervention in infected patients. The cost:benefit ratio of this measure might be decreased by applying it to selected patients chosen on the basis of risk factors, including hospital service assignment (Infect Control 1981; 2(3):227-232.)

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 2 , Issue 3 , June 1981 , pp. 227 - 232
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1981

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Center for Disease Control. National Nosocomial Infections Study Report, Annual Summary, 1976. Atlanta, Center for Disease Control, 1978.Google Scholar
2.Garibaldi, RA, Burke, JP, Dickman, ML, Smith, CB. Factors predisposing to bacteriuria during indwelling urethral catheterization. N Engl J Med 1971;291:215–9.CrossRefGoogle Scholar
3.Kunin, CM. In: Bennett, JV, Brachman, PS(eds). Hospitallnfections. Boston, Little, Brown, 1979:245.Google Scholar
4.Kunin, CM. McCormack, RC. Prevention of catheter-induced urinarv tract infections by sterile closed drainage. N Engl J Med 1966;274:1155–61.CrossRefGoogle Scholar
5.Britt, MR, Garibaldi, RA, Miller, WA, Hebertson, RM. Burke, JP. Antimicrobial prophylaxis for catheter-associated bacteriuria. Antimicrob Agents Chemother 1977:11:240–3.CrossRefGoogle ScholarPubMed
6.Kunin, CM. Finkelberg, F. Evaluation of an intraurethral lubricating catheter in prevention of catheter-induced urinarv tract infections, J Urol 1971;106:928–30.CrossRefGoogle Scholar
7.Burke, JP, Garibaldi, RA, Britt, MR, Jacobson, JA, Conti, M, Alling, DW. Prevention of catheter-associated urinary tract infections. Efficacy of daily meatal care regimens. Am J Med 1981;70:655–8.CrossRefGoogle ScholarPubMed
8.Warren, JW. Platt, R, Thomas, RJ. Rasner, B. Kass, EH. Antibiotic irrigation and catheter-associated urinary-tract infections. N Engl J Med 1978:299:570–3.CrossRefGoogle ScholarPubMed
9.Marymoni, JH Jr., Smith, JP. A program for the bacteriologie monitoring of indwelling urinary catheters. Am J Clin Path 1969:52:176–81.CrossRefGoogle Scholar
10.Haley, RW, Shactman, RH. The emergence of infection surveillance and control programs in U.S. hospitals: An assessment, 1976. Am J Epidem 1980;111:574–91.CrossRefGoogle ScholarPubMed
11.Mooney, BR. Garibaldi, RA, Britt, MR. Natural history of catheter-associated bacteriuria (colonization, infection, bacteremia). Implications for prevention. Current Chemotherapy and Infectious Disease. Washington, DC, American Society for Microbiology 1980;2:1083–4.Google Scholar
12.Burke, JP, Jacobson, JT. Jacobson, JA, Miller, WA, Britt, MR. Origins of catheter-associated bacteremia. Clin Res 1978;26:391.Google Scholar
13.Steere, AC. Stamm, WE, Martin, SM, Bennett, JV. Gram-negative rod bacteremia. IN: Bennett, JV, Brachman, PS (eds). Hospital Infections. Boston, Little, Brown, 1979:513.Google Scholar
14.Kunin, CM. Detection, Prevention and Management of Urinary Tract Infections (2nd Ed). Philadelphia, Lea and Febiger, 1974:104.Google Scholar
15.Moody, ML, Burke, JP. Infections and antibiotic use in a large private hospital. Arch Int Med 1972;130:261–6.CrossRefGoogle Scholar
16.Stevens, GP, Jacobson, JA, Burke, JP. Changing patterns of hospital infections and antibiotic use—prevalence surveys in a community hospital. Arch Int Med 1981;141:587–92.CrossRefGoogle Scholar