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The Chronic Indwelling Catheter and Urinary Infection in Long-Term–Care Facility Residents

Published online by Cambridge University Press:  02 January 2015

Philip W. Smith  and
Lindsay E. Nicolle
Philip W. Smith
Affiliation:
Health Sciences Centre, Winnipeg, Manitoba, Canada
Lindsay E. Nicolle*
Affiliation:
Health Sciences Centre, Winnipeg, Manitoba, Canada
*
Health Sciences Centre, GC430-820 Sherbrook St, Winnipeg, MB R3A 1R9, Canada
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Abstract

From 5% to 10% of residents of long-term–care facilities have urinary drainage managed with chronic indwelling catheters. These residents are always bacteriuric, usually with a complex microbiological flora of two to five organisms and a biofilm on the catheter that may contribute to obstruction. Residents with chronic indwelling catheters have increased morbidity from urinary infection compared to bacteriuric residents without chronic catheters. The most effective means to prevent infection is limitation of chronic indwelling catheter use. While appropriate catheter care and infection control precautions are recommended in managing these patients, the impact of these practices on the occurrence of urinary infection or prevention of symptomatic episodes has not been evaluated. Symptomatic infection can likely be prevented by attention to catheter care, including early recognition and replacement of obstructed catheters and prevention of catheter trauma. Appropriate use of prophylactic antimicrobial therapy prior to invasive genitourinary procedures is also necessary. Asymptomatic bacteriuria should not be treated. When symptomatic episodes occur, patients should be evaluated clinically and microbiologically and treated with appropriate antimicrobial therapy. Further technological advances in catheter material and urine drainage will be needed to have a substantial impact on the frequency of urinary infection with chronic catheter use.

Type
Topics in Long-Term Care
Information
Infection Control & Hospital Epidemiology , Volume 22 , Issue 5 , May 2001 , pp. 316 - 321
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2001

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