Skip to main content
×
Home
    • Aa
    • Aa

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

  • Philip W. Smith (a1) and Lindsay E. Nicolle (a1)
Abstract
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.

Copyright
Corresponding author
Health Sciences Centre, GC430-820 Sherbrook St, Winnipeg, MB R3A 1R9, Canada
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

10. JWA Ramsay , AJ Garnham , AB Mulhall , RA Crow , JM Bryan , I Eardley , et al. Biofilms, bacteria, and bladder catheters: a clinical study. British Journal of Urology 1989;64:395398.

12. CM Kunin . Blockage of urinary catheters. The role of micro-organisms and constituents of urine on the formation of encrustations. J Clin Epidemiol 1989;42:835842.

14. D Bergqvist , R Bronnestam , H Hedelin , A Stahl . The relevance of urinary sampling methods in patients with indwelling Foley catheters. British Journal of Urology 1980;52:9295.

17. JW Warren , D Damron , JH Tenney , JM Hoopes , B Deforge , HL Muncie Jr Fever, bacteremia and death as complications of bacteriuria in women with long-term urethral catheters. J Infect Dis 1987;155:11511158.

18. P Orr , LE Nicolle , H Duckworth , J Brunka , J Kennedy , D Murray , et al. Febrile urinary infection in the institutionalized elderly. Am J Med 1996;100:7177.

20. HL Muncie Jr JM Hoopes , DJ Damron , JH Tenney , JW Warren . Once-daily irrigation of long-term urethral catheters with normal saline. Arch Intern Med 1989;149:441443.

22. JW Warren , HL Muncie Jr M Hall-Craggs . Acute pyelonephritis associated with bacteriuria during long-term catheterization: a prospective, clinicopathological study. J Infect Dis 1988;158:13411346.

25. HJM Cools , JWM van der Meer . Restriction of long-term indwelling urethral catheterization in the elderly. British Journal of Urology 1986;58:683688.

27. PW Smith , PG Rusnak . Infection prevention and control in the long term care facility. SHEA Long-Term–Care Committee and APIC Guidelines Committee. Infect Control Hosp Epidemiol 1997;18:831849.

28. PA Tambyah , DG Maki . The relationship between pyuria and infection in patients with indwelling urinary catheters. Arch Intern Med 2000;160:673682.

29. DK Steward , GL Wood , RL Cohen , JW Smith , PA Mackowiak . Failure of the urinalysis and quantitative urine culture in diagnosing symptomatic urinary tract infections in patients with long term urinary catheters. Am J Infect Control 1985;13:159160.

30. B Alling , A Brandberg , S Seeberg , A Svanborg . Effect of consecutive antibacterial therapy on bacteriuria in hospitalized geriatric patients. Scand J Infect Dis 1975;7:201207.

31. JW Warren , WC Anthony , JM Hoopes , HL Muncie Jr Cephalexin for susceptible bacteriuria in afebrile, long-term catheterized patients. JAMA 1982;248:454458.

35. MT Cafferkey , FR Falkiner , WA Gillespie , DM Murphy . Antibiotics for the prevention of septicemia in urology. J Antimicrob Chemother 1982;9:471477.

36. LA Jewes , WA Gillespie , A Leadbetter , B Myers , RA Simpson , MJ Stower , et al. Bacteriuria and bacteremia in patients with long-term indwelling catheters—a domiciliary study. J Med Microbiol 1988;26:6165.

37. T Bregenzer , R Frei , AF Widmer , W Seiler , W Probst , G Mattarelli , et al. Low risk of bacteremia during catheter replacement in patients with long-term urinary catheters. Arch Intern Med 1997;157:521525.

39. LE Nicolle . A practical approach to the management of complicated urinary tract infection. Drugs 1997;53:583592.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Infection Control & Hospital Epidemiology
  • ISSN: 0899-823X
  • EISSN: 1559-6834
  • URL: /core/journals/infection-control-and-hospital-epidemiology
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 7 *
Loading metrics...

Abstract views

Total abstract views: 523 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 23rd September 2017. This data will be updated every 24 hours.