Literature review of catheter-acquired urinary tract infection prevention

Urinary Tract Infection and Prevention

Research write 5 literature review catheter acquired urinary tract infection prevention.

Catheter-associated (CA) bacteriuria is health care infection associated with the wide spreed urinary catheterization in hospitals and long-term care facilities worldwide. Considerable costs, personnel, time are spent by health care institutions to minimize the infection rate of CA infections, especially the urinary tract infections - CA urinary tract infections (Graves N. et al., 2007). Urinary catheterisation is defined as an intervention to enable emptying of the bladder by insertion of a catheter. Indwelling urinary catheterisation is categorised as either; short-term - less than 28 days, or long-term - greater than 28 days (Tambyah PA & DG., 2000). Urinary tract infections (UTIs) have been shown to be one of the most common in healthcare-associated infection (HCAI) with up to 80% related to the presence of urinary catheter (Gould CV, Umscheid CA, Agarwai RK, Kuntz G, & DA., 2009). A 2009, pilot project for a European HCAI point prevalence study in long-term care facilities involving 14,672 residents in 13 European countries found that urinary tract infections accounted for 30% of the reported HCAIs (Nicolle L, Classen D, Arias KM, Podgorny K, & Anderson DJ, 2008)

Literature Review

The presence of bacteria in urine (bacteriuria) signifies either colonisation (asymptomatic bacteriuria) or infection. Bacteriuria can be found in both catheterised and non-catheterisedpatients, but 10% - 30% of patients with a catheter in situ for greater than 30 days will develop bacteriuria compared to 1% of non-catheterised patients (Nicolle L. et al., 2008)It has been estimated than more that 90% of catheter-associated bacteriuria may reflect colonisation rather than infection.10) However a definitive diagnosis of CAUTI is not evidence-based (Tambyah PA & DG., 2000) Laboratory criteria for differentiating between CAUTI and asymptomatic bacteriuria have not been established.

The presence of a urinary catheter and the length of time it remains in a patient is a contributory factor to the development of a catheter-associated urinary tract infection (CAUTI) (Cope M. et al., 2009). It has been established that the risk of acquiring an infection increases by 5% each day the catheter remains in side. An average of 25% of hospitalised patients are catheterised at some stage during their admission, therefore, it is critical that procedures and practices are factored in to reduce the risks of infection (Gould CV et al., 2009)

The natural defence mechanisms of the urinary tract include the length of the urethra and urine flow which washes microorganisms away from the bladder. Urethral catheterisation interferes with these defence mechanisms. The most common organisms to cause CAUTI derive from the patient's perineal flora or from the hands of HCWs; these organisms may include; Escherichia coli, Enterococcus spp., Klebsiella spp., Pseudomonas spp., Enterobacter spp., or Candida spp (Gould CV et al., 2009)

Measures to reduce and prevent occurrence of CAUTI