Bacteriuria and bacteraemia in patients with long-term indwelling catheters-a domiciliary study

Abstract

Summary. Men with indwelling catheters and men and women with suprapubic catheters were studied in their homes. Urine and blood were cultured and body temperature recorded after every catheter change. Nearly all patients had infected urine after 4 weeks of catheterisation, and all had bacteriuria after longer periods, usually with a mixture of organisms. Culture on selective media revealed a wider range of organisms than was detected on routine C.L.E.D. and blood agar with antibiotic sensitivity disks, but routine culture gave adequate information for clinical purposes. Bacteraemia was demonstrated after 20 of 197 changes of urethral catheter and after one of 19 changes of suprapubic catheter; but no patient had pyrexia or other symptoms. However, two had rigors on other occasions. When assessing "risk factors" for blood-stream infection in catheterised patients, it is important to record the total incidence of bacteraemia, asymptomatic as well as symptomatic.

Diagnosis, Prevention, and Treatment of Catheter-Associated Urinary Tract Infection in Adults: 2009 International Clinical Practice Guidelines from the Infectious Diseases Society of America

“…In a study describing 115 men and women with long-term catheterization (most patients did not have a neurogenic bladder) who were bacteriuric and living at home, Jewes et al [73] reported bacteremia after 20 (10%) of 197 urethral catheter changes and 1 (5%) of 19 suprapubic catheter changes. All bacteremic episodes were asymptomatic, and patients were afebrile.…”

“…Although bacteremias in LTCFs are uncommon [69,72], urinary catheterization was associated with a 39-fold increase in the incidence of bacteremia in one study [71]. Transient asymptomatic bacteremia occurs in ∼4% of bacteriuric patients with long-term catheterization whose indwelling urethral or suprapubic catheter is removed or replaced [73][74][75].…”

European and Asian guidelines on management and prevention of catheter-associated urinary tract infections

“…Transient asymptomatic bacteraemia is common during initial catheter insertion or during catheter exchange in chronically catheterised patients [38] (III). The risk of bacteraemia during initial catheter insertion is similar, whether there is a pre-existing UTI (7%) or sterile urine (8.2%) [39,40] (IIa).…”

Lock-Out Valve to Decrease Catheter-Associated Urinary Tract Infections

“…Indwelling urinary catheters have the highest risk of nosocomial infection due to the fact that they remain in the bladder for a long period of time and allow microbial colonization and invasion [1]. In general, catheter-associated urinary tract infection (CAUTI) is the most common nosocomial infection in the United States, accounting for nearly a third of all hospital infections [2, 3].…”