1887

Abstract

To determine micro-organisms attached to removed urethral catheters and relate this to patient-specific information. Indwelling urethral catheters were collected from patients at a UK teaching hospital. The balloon and lumen were sonicated, and micro-organisms were enumerated. Catheter specimen urine results were retrospectively reviewed. and were the most common isolates from 61 catheters. 19.7% of patients received antibiotics and 25 % of those had a multi-drug-resistant (MDR) organism in the lumen. Only 2.04% of catheters from patients not receiving antibiotics had a MDR organism. All lumens were colonized irrespective of antibiotic use. Symptom presentation did not correlate with numbers of colonizing organisms or species. Despite heavy colonization, only 8/61 patients were symptomatic. Indwelling urinary catheters in place for ≥10 days were universally colonized and there was no correlation with symptom presentation. Symptom presentation remains the most important factor for defining catheter-associated urinary tract infection.

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/content/journal/jmm/10.1099/jmm.0.000946
2019-04-01
2020-01-23
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References

  1. Bishara J, Leibovici L, Huminer D, Drucker M, Samra Z et al. Five-year prospective study of bacteraemic urinary tract infection in a single institution. Eur J Clin Microbiol Infect Dis 1997;16:563–567 [CrossRef]
    [Google Scholar]
  2. Tambyah P, Maki D. The relationship between pyuria and infection in patients with indwelling urinary catheters: a prospective study with 761 patients. JAMA Intern Med 2000;160:673–677
    [Google Scholar]
  3. Elvy J, Colville A. Catheter associated urinary tract infection: what is it, what causes it and how can we prevent it?. J Infect Prev 2009;10:36–41 [CrossRef]
    [Google Scholar]
  4. Sievert DM, Ricks P, Edwards JR, Schneider A, Patel J et al. Antimicrobial-resistant pathogens associated with healthcare-associated infections summary of data reported to the National healthcare safety network at the Centers for disease control and prevention, 2009–2010. Infect Control Hosp Epidemiol 2013;34:1–14 [CrossRef]
    [Google Scholar]
  5. Gross PA, Patel B. Reducing antibiotic overuse: a call for a national performance measure for not treating asymptomatic bacteriuria. Clin Infect Dis 2007;45:1335–1337 [CrossRef]
    [Google Scholar]
  6. Bergqvist D, Bronnestam R, Hedelin H, Stahl A. The relevance of urinary sampling methods in patients with indwelling Foley catheters. Br J Urol 1980;52:92–95 [CrossRef]
    [Google Scholar]
  7. Giske C, Martinez-Martinez L, Canton R, Stefani S, Skov R et al. EUCAST guidelines for detection of resistance mechanisms and specific resistances of clinical and/or epidemiological importance. European Committee on Antimicrobial Susceptibility Testing. 2013
  8. European Committee on Antimicrobial Susceptibility Testing Antimicrobial susceptibility testing: EUCAST disc diffusion method v5.0. January 2015
  9. Stickler DJ. Clinical complications of urinary catheters caused by crystalline biofilms: something needs to be done. J Intern Med 2014;276:120–129 [CrossRef]
    [Google Scholar]
  10. Hedelin H, Bratt CG, Eckerdal G, Lincoln K. Relationship between urease-producing bacteria, urinary pH and encrustation on indwelling urinary catheters. Br J Urol 1991;67:527–531 [CrossRef]
    [Google Scholar]
  11. Warren JW, Tenney JH, Hoopes JM, Muncie HL, Anthony WC. A prospective microbiologic study of bacteriuria in patients with chronic indwelling urethral catheters. J Infect Dis 1982;146:719–723 [CrossRef]
    [Google Scholar]
  12. Montgomerie JZ, McCary A, Bennett CJ, Young M, Matias B et al. Urethral cultures in female patients with a spinal cord injury. Spinal Cord 1997;35:282–285 [CrossRef]
    [Google Scholar]
  13. Scottish Intercollegiate Guidelines Network (SIGN) Management of suspected bacterial urinary tract infection in adults (SIGN publication no. 88) Edinburgh: Healthcare Improvement Scotland; 2012
  14. Hooton TM, Bradley SF, Cardenas DD, Colgan R, Geerlings SE et al. Diagnosis, prevention, and treatment of catheter-associated urinary tract infection in adults: 2009 international clinical practice guidelines from the infectious diseases Society of America. Clin Infect Dis 2010;50:625–663 [CrossRef]
    [Google Scholar]
  15. Nicolle LE. Catheter associated urinary tract infections. Antimicrob Resist Infect Control 2014;3:23 [CrossRef]
    [Google Scholar]
  16. Ganderton L, Chawla J, Winters C, Wimpenny J, Stickler D. Scanning electron microscopy of bacterial biofilms on indwelling bladder catheters. Eur J Clin Microbiol Infect Dis 1992;11:789–796 [CrossRef]
    [Google Scholar]
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