"Catheter-Associated Urinary Tract Infections: Treatment and Prevention" is a delightful example of a paper on infections. This particular topic has been chosen because with proper knowledge and application, a lot of complications can be avoided and the patient suffering from CAUTI can recover very well in time. It is one of the most frequent infections today and the pain that the patient goes through is excruciating. Catheter-associated urinary tract infections, otherwise known as CAUTI can get extremely complicated and can cause cystitis, pyelonephritis, gram-negative bacteremia, prostatitis, epididymitis, and orchitis in males and, less commonly, endocarditis, vertebral osteomyelitis, septic arthritis, endophthalmitis, and meningitis in any patient (CDC, 2009). Informatics Catheter-related infections can lead to serious complications, resulting in an increase in mortality and time of stay in the medical facility.
The issue of mortality and increased length of time spending in health care is a direct consequence of fiddling with unmeasured variables involved. This emphasizes the importance of benefits and risks involved in treatments including antibiotics to take care of catheter-related infections. Facts Some facts regarding CAUTI are; The daily risk of developing CAUTI is 3%-7% even in acute care. Of all institutionally acquired infections, CAUTI constitutes 40% of those(CDC, 2009). Only 8% chance exists of developing CAUTI in-home care setting Very small evidence exists regarding CAUTI developing in long-term users of suprapubic catheter compared to urethral catheter users. Conditions for CAUTI Bacteriuria: Urine containing bacteria Catheter users who have been using it for a long time (over a month) have a high concentration of bacterial urine.
This bacterium is polymicrobial. Asymptomatic bacteriuria has a very peculiar presence. One is said to have this bacteria in his urine when just one microorganism is found in two consecutive urine samples with a condition that more than 100,000/Colony Forming Units are found without any lower urinary tract symptoms. People have different tendencies of acquiring bacteriuria at different rates.
Incidence of conversion from sterile urine to bacteriuria happens at around 10% in a day. Asymptomatic bacteriuria is present in almost every user of the catheter (this is specifically true when the catheter has been in use for more than 30 days). Asymptomatic bacteriuria probably may not be treated in patients who are regular users of catheters. Only a handful of selected cases will be treated, like those who are scheduled for urological surgery or are pregnant. Bacteremia: Infection in the bloodstream This is a life-threatening scenario.
Almost 3% of all patients with catheters are likely to develop bacteremia. CAUTI is the second most common agent of nosocomial bloodstream infection. Diagnosis of CAUTI Diagnosing CAUTI requires finding bacteriuria on top of an elevated white blood cell count (WBC). Risk Factors Some people are more prone to acquiring CAUTI, whereas some catheter management techniques might also contribute to CAUTI. The following table will clear the idea: Catheter Factors Individual Factors The catheter is intact for more than 6 days Pregnant female Inserted outside the operating room Malnourishment or has a chronic illness The catheter is used to measure the urinary output Diabetic Mellitus or has azotemia (creatinine > 2.0 mg/dL) The catheter is positioned improperly Has ureteral stent or has other infection sites The catheter is not handled as a closed system Catheter implanted after a fractured hip and lives in a nursing home Treatment (Symptomatic CAUTI) Identify the microorganisms that have caused the infection and need to separate (differentiate) between this particular bacteria and other bacteria found in a catheter (Society). Initial treatment can be empirical but later on, the therapy should have a solid basis in sensitivity testing and culture reports (Society). Urosepsis is a very intense complication of catheters and may require aggressive antibiotic treatment or even hospitalization. Prevention (CAUTI) The first step in preventing CAUTI is removing the catheter and using any other alternative for urine drainage.
If it becomes inevitable to keep the catheter on then follow the instructions in the table. General Principles of Care Type of Catheter Always use a sterile catheter insertion Silver-alloy impregnated catheters for long term usage is not recommended Try to use the smallest size of lumen and balloon Short term usage of silver alloy can help in reducing the incidence of bacteremia and CAUTI Shorten the time span used for catheterization Hydrogel and Silicone catheters are recommended for people using catheters for more than 14 days. Make sure that a closed drainage system is used Collection bag must be placed below the level of tubing Perineal Care must be used whenever possible. Prevent tension/contraction of the catheter There is insufficient evidence to support or refute the usage of excessive intake of fluids to prevent CAUTI.
It can be tried as it may be helpful. Applying these methods and techniques will help the patients in recovering from their condition quickly.
Following these principles will greatly improve the health of the patient but most importantly it will help prevent complications.
Barbara W. Trautner, M. P. (n.d.). Management of Catheter-Associated Urinary Tract Infection (CAUTI). Retrieved from http://www.ncbi.nlm.nih.gov: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2865895/
CDC. (2009, March). Device Associated Events CAUTI. Retrieved from http://www.cdc.gov: http://www.cdc.gov/nhsn/pdfs/pscManual/7pscCAUTIcurrent.pdf
Laura A. Stokowski, R. M., & Editor, M. A. (n.d.). Preventing Catheter-Associated Urinary Tract Infections: Prevention of CAUTI. Retrieved from http://www.medscape.com: http://www.medscape.com/viewarticle/587464_4
Lo E, N. L. (n.d.). Agency of Healthcare Research and Quality. Retrieved from http://www.guideline.gov: http://www.guideline.gov/content.aspx?id=13394
Society, W. O. (n.d.). Wound Ostomy and Continence Nursing Society. Retrieved from http://www.wocn.org: http://www.wocn.org/pdfs/WOCN_Library/Fact_Sheets/cauti_fact_sheet.pdf