Preventing Infections Associated with Urinary Catheters

1. PreventingInfectionsAssociatedwithUrinaryCatheters

2. Introduction • Urinary Tract Infections (UTI) most common infection acquired in hospital • Infections that is easily can be more difficult in the elderly and patients with catheters due to developing antimicrobial resistance infections • Normal bladder has a number of defenses • Urethra is difficult to have microorganisms to pass along • Epithelial cells that line the bladder are resistant to bacterial adherence • Process of urination helps to flush out bacteria and difficult to reach the bladder

3. Introduction Presence of a catheter interferes with and a major predisposing factor for health care associated UTIs Urinary catheters are widely used device in hospitals and in nursing homes Used often in elderly and debilitated and those with neurological injuries and those catharized for long periods of times and therefore at greater risk of acquiring recurrent UTIs Repeated use of antibiotic encourages the emergence of antibiotic resistant pathogens and can increase the risk of bloodstream infections

4. Complications Catheter Associated UTI • Vulnerable to many complications including inflammation, mechanical trauma, urethral strictures, calculi, and pyelonephritis with chronic inflammation of kidneys • Bacteria originating in the urinary tract may also circulate around the body and cause secondary infections at other sites

5. Risk Factors for Catheter Associated Urinary Tract Infection • Bacteria can enter the bladder in one of three ways • At the time of insertion of the catheter • May tread alongside the side of the catheter • May travel the inside of the lumen of the catheter • In women need to think about the short urethra enables bacteria from the perineum reach the bladder more easily than men • In men more than likely the bacteria gains access to the bladder via the lumen of the catheter usually due to cross contamination from staff • Can happen due to mishandling of the urinary bag

6. Risk Factors for Catheter Associated Urinary Tract Infection • Insertion of catheter using sterile technique • Handling of the drainage bag • Cleaning the perineal area • Cleaning of the catheter tubing • Cleaning the spout after draining • Handling of tubing and catheter to avoid mechanical trauma

7. Intermittent Catheterization • Done for variety of reasons • Can be done by self or caregiver • Hydrophilic, coated catheters may slightly decrease the risk of contamination

8. Other Information Catheter size-most common sizes for retention catheters are those with balloons that hold 10 to 30 mL of sterile water Frequency of catheter replacement is usually every 30 days, but need to check facility policies Keeping the drainage a closed system-specimens should be obtained from ports