Catheter-Related Urinary Tract Infections (Ca-Uti)

A catheter-related UTIs (CAUTI) is a urinary tract infection, in which the positive culture was taken while a dwell was laid urinary catheter for> 2 calendar days. Patients with indwelling catheters are predisposed to bacteriuria and urinary tract infections. The symptoms can be vague, or suggestive of sepsis. The diagnosis depends on the present symptoms. The investigation includes urinalysis and culture after the catheter was removed and before a new wurd used. The most effective preventive measures are the avoidance of unnecessary catheterization and removing catheters as soon as possible.

Bacteria can enter the bladder during insertion of the catheter, through the catheter lumen, or from outside the catheter. A biofilm develops around the outside of the catheter and on the uroepithelium. Bacteria move into this biofilm that protects them from the mechanical flow of urine, the defense mechanisms of the host, before antibiotics, so a bacterial removal is difficult. Even with thorough aseptic introduction and cleaning of the catheter, the probability is to develop a significant bacteriuria in each day on which the catheter is located at 3-10%. Of the patients who develop bacteriuria, 10-25% get symptoms of urinary tract infections. Less developed sepsis.

A catheter-related UTIs (CAUTI) is a urinary tract infection, in which the positive culture was taken while a dwell was laid urinary catheter for> 2 calendar days. Patients with indwelling catheters are predisposed to bacteriuria and urinary tract infections. The symptoms can be vague, or suggestive of sepsis. The diagnosis depends on the present symptoms. The investigation includes urinalysis and culture after the catheter was removed and before a new wurd used. The most effective preventive measures are the avoidance of unnecessary catheterization and removing catheters as soon as possible. Bacteria can enter the bladder during insertion of the catheter, through the catheter lumen, or from outside the catheter. A biofilm develops around the outside of the catheter and on the uroepithelium. Bacteria move into this biofilm that protects them from the mechanical flow of urine, the defense mechanisms of the host, before antibiotics, so a bacterial removal is difficult. Even with thorough aseptic introduction and cleaning of the catheter, the probability is to develop a significant bacteriuria in each day on which the catheter is located at 3-10%. Of the patients who develop bacteriuria, 10-25% get symptoms of urinary tract infections. Less developed sepsis. Among the risk factors for HWI include the duration of catheterization, female gender, diabetes mellitus, the opening of a closed system and suboptimal aseptic techniques. Indwelling catheter may predispose for mushroom-related UTI. UTIs may also in women during the days after a catheter was removed, develop. Symptoms and discomfort patients with catheter-related Haenwegsinfektionen (CAUTI), some of the typical UTI symptoms (dysuria, frequency) can not have, but they can complain of feeling to feel the need to urinate or suprapubic pain. However, such symptoms of UTI of the lower urinary tract due to obstruction of the catheter or the development of bladder stones may be caused. Symptoms of acute or chronic pyelonephritis may develop even without the typical symptoms of the urinary tract. Patients may have non-specific symptoms such as malaise, fever, flank pain, anorexia, decreased consciousness and signs of sepsis. Diagnostic urinalysis and urine culture in patients with symptoms or at high risk for sepsis tests are performed only in patients that may require treatment, including those who have symptoms and who are at high risk for developing sepsis. Patients with granulocytopenia patients with organ transplant, the immunosuppressants are taking pregnant patients who undergo a urological procedure The diagnostic tests include urinalysis and urine culture. When bacteremia is suspected, blood cultures are created. Urine cultures should preferably take place after the exchange of the catheter (to avoid cultivation of accumulated bacteria), then by a direct needle stick out of the catheter, all be removed with an aseptic technique, so that contamination of the sample is minimized. In women, in which a catheter was removed, it is recommended to apply a urine culture within 48 hours, regardless of whether symptoms or not. Antibiotics asymptomatic low-risk patients are not treated. Symptomatic and high-risk patients are treated with antibiotics and supportive measures. The catheter should be replaced if the treatment begins. Choice of empirical antibiotic such as acute pyelonephritis. Sometimes vancomycin is added to the therapy. should connect antibiotic with the narrowest spectrum of action, based on the culture and sensitivity test, are used. The optimal duration is not well established, but 7 to 14 days are appropriate in patients who had a satisfactory clinical response, including resolution of systemic manifestations. Asymptomatic women and men, where recently a catheter was removed and where a UTI was diagnosed on the basis of urine culture should be treated on the basis of culture results. The optimal duration of therapy is unknown. Prevention The most effective preventive measures to avoid catheterization and remove the catheter as soon as possible. By optimizing aseptic conditions and maintain a closed drainage system, the risk is also reduced. How often and even if indwelling catheters are changed regularly, is not known. Intermittent catheterization carries a lower risk than the use of an indwelling catheter and should be used instead, if possible. An excessive antibiotic prophylaxis and antibiotic catheters are patients who require indwelling catheter, no longer recommended. Key points Long-term use of permanent urinary catheters increases the risk of bacteriuria, though bacteriuria is usually asymptomatic. Symptomatic UTI may manifest with systemic symptoms (eg., Fever, altered mental status, decreased blood pressure) and few or no symptoms typical of UTI. Perform urinalysis and urine culture in patients with symptoms or at high risk for sepsis (z. B. for immune weakening) Treat in a similar way to other complicated urinary tract infections. Whenever possible, avoid the use of catheters or remove them at the first opportunity.

Health Life Media Team

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