Impact of Foley Catheter Placement by Medical Students on Rates of Postoperative Urinary Tract Infection

2018 ◽  
Vol 227 (5) ◽  
pp. 496-501 ◽  
Author(s):  
Ibrahim Sultan ◽  
Ahmet Kilic ◽  
George Arnaoutakis ◽  
Arman Kilic
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Medical Students ◽  
Tract Infection ◽  
Foley Catheter ◽  
Catheter Placement

scholarly journals Bacterial Biofilms and Catheters: A Key to Understanding Bacterial Strategies in Catheter-Associated Urinary Tract Infection

1992 ◽  
Vol 3 (5) ◽  
pp. 261-267 ◽  
Author(s):  
J Curtis Nickel ◽  
J William Costerton
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Foley Catheter ◽  
Drainage System ◽  
Complicated Urinary Tract Infection ◽  
Bacterial Biofilms ◽  
Large Measure ◽  
Closed Drainage ◽  
The Individual

Despite major technological improvements in catheter drainage systems, the indwelling Foley catheter remains the most common cause of nosocomial infection in medical practice. By approaching this common complicated urinary tract infection from the perspective of the biofilm strategy bacteria appear to use to overcome obstacles to produce bacteriuria, one appreciates a new understanding of these infections. An adherent biofilm of bacteria in their secretory products ascends the luminal and external surface of the catheter and drainage system from a contaminated drainage spigot or urethral meatus into the bladder. If the intraluminal route of bacterial ascent is delayed by strict sterile closed drainage or addition of internal modifications to the system, the extraluminal or urethral route assumes greater importance in the development of bacteriuria, but takes significantly longer. Bacterial growth within these thick coherent biofilms confers a large measure of relative resistance to antibiotics even though the individual bacterium remains sensitive, thus accounting for the failure of antibiotic therapy. With disruption of the protective mucous layer of the bladder by mechanical irritation, the bacteria colonizing the catheter can adhere to the bladder’s mucosal surface and cause infection. An appreciation of the role of bacterial biofilms in these infections should suggest future directions for research that may ultimately reduce the risk of catheter-associated infection.

scholarly journals Chronic indwelling foley catheter, a risk factor for catheter associated urinary tract infection.

2020 ◽  
Vol 27 (11) ◽  
pp. 2300-2304
Author(s):  
Muhammad Saifullah ◽  
Moin Anwar ◽  
Hanan Noor ◽  
Muhammad Akmal ◽  
Ghulam Mehboob Subhani ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Urinary Infection ◽  
Foley Catheter ◽  
Cross Sectional Study ◽  
Urethral Catheter ◽  
Cross Sectional ◽  
Catheter Tip ◽  
Aseptic Conditions

Catheter associated infection is one of commonest infection which affects hospital admitted patients. Indwelling urethral catheters which are kept in place for 30 days or less are called short term. Whereas, when catheter placement exceeds 30 days, it is known as chronic or long term. Objectives: This study was intended to investigate the frequency of urinary tract infection caused by chronic indwelling urethral catheters. Study Design: Cross Sectional study. Setting: Department of Urology & Renal Transplantation, Allied Hospital, Faisalabad. Period: 6 months between 01-12-2015 to 31-05-2016. Material & Methods: Informed consent was taken from all the 100 patients which were selected for the research purpose. Under aseptic conditions, indwelling urethral catheter was replaced. The Foley catheter tip which we had taken out was cut and separated. It was delivered to the pathologist for culture and sensitivity in a secured axenic container. Diabetes was ruled out using blood sugar fasting levels. Data was recorded using a proforma. Results: In our study, out of 100 cases with chronic supra-pubic or urethral Foley catheter, 53% cases (n=53) were aged below 50 years while 47% (n=47) were aged above 50 years. Furthermore, 95% patients (n=95) were men and only 5% (n=5) were women. 18% participants of our study were recorded to have urinary infection associated with chronic catheterization. Conclusion: We found that urinary infection affects the patients having chronic indwelling urethral catheters significantly. Therefore, it is justified to assess every patient having urethral catheter for possible urinary infection.

scholarly journals Hospital-Acquired Urinary Tract Infections: Results of a Cohort Study Performed in an Internal Medicine Department

2017 ◽  
Vol 30 (9) ◽  
pp. 608 ◽  
Author(s):  
Maria João Lobão ◽  
Paulo Sousa
Keyword(s):  
Internal Medicine ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Urinary Tract Infections ◽  
Catheter Placement ◽  
Medicine Department ◽  
Bladder Catheter ◽  
Tract Infections ◽  
Hospital Acquired

Introduction: Urinary tract infections are the most frequent healthcare associated infections, being related to both high costs and morbidity. Our intention was to carry out an epidemiological characterization of hospital acquired urinary tract infections that occurred in an internal medicine department of a Portuguese hospital.Material and Methods: Retrospective cohort study (historic cohort). Data were analysed from a systematic random sample of 388 patients, representative of the 3492 admissions occurred in 2014 in that department.Results: One in four patients underwent the placement of a bladder catheter [24.7% (n = 96); 95% CI: 20% - 29%], 36.5% (95% CI: 33% - 48%) of which in the absence of clinical criteria for that procedure. The global cumulative incidence rate for nosocomial urinary tract infections was 4.6% (95% CI: 2.5% - 6.7%). Most hospital acquired urinary tract infections (61.1%) were related to bladder catheter use. We quantified 3.06 infections / 1000 patient-days and 14.5 infections / 1000 catheter-days. Catheter associated urinary tract infection occurred at an early stage of hospitalization. The vast majority of patients (66.7%) that developed a catheter associated urinary tract infection were subjected to bladder catheter placement at emergency department. Seventy one per cent of catheter associated urinary tract infection occurred in patients that were subjected to bladder catheter placement without criteria.Discussion: These results point to an excessive and inadequate use of urinary catheters, highlighting the need for judicious use taking into account the formal clinical indications. The incidence of catheter associated urinary tract infection is similar to what we found in other studies. Nevertheless we found a very high incidence density per catheter-days that may foresee a problem probably related to the absence of early withdrawal of the device, and to both bladder catheter placement and maintenance practices. A significant part of catheter associated urinary tract infection occurred in patients that had the bladder catheter placed in the emergency department, before the admission to the internal medicine ward, which highlights the need to assess the urinary catheterization practices in those departments.Conclusion: The high rate of catheter associated urinary tract infection that occurred in the absence of bladder placement indication reinforces the need to implement prevention strategies that contemplate the reduction of its use. Emergency departments should be part of quality improvement projects in this area. Causes for the early onset of catheter associated urinary tract infection in this cohort should be investigated.

Emergency Department Catheter-Associated Urinary Tract Infection Prevention: Multisite Qualitative Study of Perceived Risks and Implemented Strategies

2015 ◽  
Vol 37 (2) ◽  
pp. 156-162 ◽  
Author(s):  
Eileen J. Carter ◽  
Daniel J. Pallin ◽  
Leslie Mandel ◽  
Corine Sinnette ◽  
Jeremiah D. Schuur
Keyword(s):  
Emergency Department ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Urinary Catheter ◽  
Catheter Placement ◽  
Inpatient Setting ◽  
Insertion Technique ◽  
Medical Reason ◽  
Perceived Risks

BACKGROUNDExisting knowledge of emergency department (ED) catheter-associated urinary tract infection (CAUTI) prevention is limited. We aimed to describe the motivations, perceived risks for CAUTI acquisition, and strategies used to address CAUTI risk among EDs that had existing CAUTI prevention programs.METHODSIn this qualitative comparative case study, we enrolled early-adopting EDs, that is, those using criteria for urinary catheter placement and tracking the frequency of catheters placed in the ED. At 6 diverse facilities, we conducted 52 semistructured interviews and 9 focus groups with hospital and ED participants.RESULTSAll ED CAUTI programs originated from a hospitalwide focus on CAUTI prevention. Staff were motivated to address CAUTI because they believed program compliance improved patient care. ED CAUTI prevention was perceived to differ from CAUTI prevention in the inpatient setting. To identify areas of ED CAUTI prevention focus, programs examined ED workflow and identified 4 CAUTI risks: (1) inappropriate reasons for urinary catheter placement; (2) physicians’ limited involvement in placement decisions; (3) patterns of urinary catheter overuse; and (4) poor insertion technique. Programs redesigned workflow to address risks by (1) requiring staff to specify the medical reason for catheter at the point of order entry and placement; (2) making physicians responsible for determining catheter use; (3) using catheter alternatives to address patterns of overuse; and (4) modifying urinary catheter insertion practices to ensure proper placement.CONCLUSIONSEarly-adopting EDs redesigned workflow to minimize catheter use and ensure proper insertion technique. Assessment of ED workflow is necessary to identify and modify local practices that may increase CAUTI risk.Infect. Control Hosp. Epidemiol. 2016;37(2):156–162

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