Pathophysiology, Treatment, and Prevention of Catheter-Associated Urinary Tract Infection

Abstract

Urinary tract infections (UTIs) are among the most common microbial infections in humans and represent a substantial burden on the health care system. UTIs can be uncomplicated, as when affecting healthy individuals, or complicated, when affecting individuals with compromised urodynamics and/or host defenses, such as those with a urinary catheter. There are clear differences between uncomplicated UTI and catheter-associated UTI (CAUTI) in clinical manifestations, causative organisms, and pathophysiology. Therefore, uncomplicated UTI and CAUTI cannot be approached similarly, or the risk of complications and treatment failure may increase. It is imperative to understand the key aspects of each condition to develop successful treatment options and improve patient outcomes. Here, we will review the epidemiology, pathogen prevalence, differential mechanisms used by uropathogens, and treatment and prevention of uncomplicated UTI and CAUTI.

Urinary Catheter Coating Modifications: The Race against Catheter-Associated Infections

“…Despite numerous prevention and treatment strategies [125], CAUTIs are still a major health care burden. Extensive research has been focused in prevention approaches, targeting microbial adhesion, subsequent colonization, and biofilm formation.…”

“…In conclusion, antibiotic-coated catheters are promising; however, many pathogens that cause CAUTIs are becoming resistant to even the last line of defense antibiotics such as vancomycin [125]. The use of antibiotics is deterred by the bacteria's ability to become resistant to antibiotics and to form biofilms on the catheter, generating further antibiotic tolerance [126,127].…”

“…Another issue arises from the media itself, it was discovered that in mice and humans, urinary catheterization causes physical trauma to the lining of the bladder, inducing an inflammatory response and consequently, changing the bladder environment [66,125,[163][164][165][166]. As part of the inflammatory response, serum proteins are released and accumulated into the bladder and deposited onto the urinary catheter [64][65][66]150,167].…”

Pseudomonas aeruginosa: Diseases, Biofilm and Antibiotic Resistance

“…UTI might be simple, in terms of affecting healthy people, or complicated, in terms of impacting people with compromised host defenses and/or urodynamics, like the ones with urinary catheter, while there were some differences between un-complicated UTI as well as catheter associated UTIs (CAUTIs) in the clinical manifestations, pathophysiology and causative organisms. Thus, uncomplicated CAUTI and UTI might not be similarly approached, or the risks of complications and treatment failure might be increased [30]. Also, complicated UTI (cUTI), occurs in immuno-compromised patients or in the patients with functional or structural abnormalities of the urinary tract (UT), were related to high treatment failure rates and dangerous complications, particularly relapse as well as the development related to antibiotic resistance [31].…”

Culture-Positivity and Sensitivity in Post-Surgical Patients in a Tertiary Care Hospital

“…Duration and type of prophylactic antibiotics received by the patient matters a lot in the development of postoperative infections along with patient factors as well. 8 The increasing poly antimicrobial resistance amongst hospital pathogens also poses a great threat. 9 Usually wound, blood, sputum, fluid, stool and urine samples are sent for culture testing to identify microbial presence, growth as well as sensitivity and resistance to specific antibiotics.…”