Logo of eidLink to Publisher's site
Emerg Infect Dis. 2001 Mar-Apr; 7(2): 342–347.
PMCID: PMC2631699

Engineering out the risk for infection with urinary catheters.

Abstract

Catheter-associated urinary tract infection (CAUTI) is the most common nosocomial infection. Each year, more than 1 million patients in U.S. acute-care hospitals and extended-care facilities acquire such an infection; the risk with short-term catheterization is 5% per day. CAUTI is the second most common cause of nosocomial bloodstream infection, and studies suggest that patients with CAUTI have an increased institutional death rate, unrelated to the development of urosepsis. Novel urinary catheters impregnated with nitrofurazone or minocycline and rifampin or coated with a silver alloy-hydrogel exhibit antiinfective surface activity that significantly reduces the risk of CAUTI for short-term catheterizations not exceeding 2-3 weeks.

Full Text

The Full Text of this article is available as a PDF (164K).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Stamm WE. Catheter-associated urinary tract infections: epidemiology, pathogenesis, and prevention. Am J Med. 1991 Sep 16;91(3B):65S–71S. [PubMed]
  • Warren JW. Catheter-associated urinary tract infections. Infect Dis Clin North Am. 1997 Sep;11(3):609–622. [PubMed]
  • Kunin CM, McCormack RC. Prevention of catheter-induced urinary-tract infections by sterile closed drainage. N Engl J Med. 1966 May 26;274(21):1155–1161. [PubMed]
  • Garibaldi RA, Mooney BR, Epstein BJ, Britt MR. An evaluation of daily bacteriologic monitoring to identify preventable episodes of catheter-associated urinary tract infection. Infect Control. 1982 Nov-Dec;3(6):466–470. [PubMed]
  • Stark RP, Maki DG. Bacteriuria in the catheterized patient. What quantitative level of bacteriuria is relevant? N Engl J Med. 1984 Aug 30;311(9):560–564. [PubMed]
  • Maki DG. Nosocomial bacteremia. An epidemiologic overview. Am J Med. 1981 Mar;70(3):719–732. [PubMed]
  • Krieger JN, Kaiser DL, Wenzel RP. Urinary tract etiology of bloodstream infections in hospitalized patients. J Infect Dis. 1983 Jul;148(1):57–62. [PubMed]
  • Bryan CS, Reynolds KL. Hospital-acquired bacteremic urinary tract infection: epidemiology and outcome. J Urol. 1984 Sep;132(3):494–498. [PubMed]
  • Platt R, Polk BF, Murdock B, Rosner B. Mortality associated with nosocomial urinary-tract infection. N Engl J Med. 1982 Sep 9;307(11):637–642. [PubMed]
  • Kunin CM, Douthitt S, Dancing J, Anderson J, Moeschberger M. The association between the use of urinary catheters and morbidity and mortality among elderly patients in nursing homes. Am J Epidemiol. 1992 Feb 1;135(3):291–301. [PubMed]
  • Tambyah PA, Maki DG. Catheter-associated urinary tract infection is rarely symptomatic: a prospective study of 1,497 catheterized patients. Arch Intern Med. 2000 Mar 13;160(5):678–682. [PubMed]
  • Patton JP, Nash DB, Abrutyn E. Urinary tract infection: economic considerations. Med Clin North Am. 1991 Mar;75(2):495–513. [PubMed]
  • Jarvis WR, Martone WJ. Predominant pathogens in hospital infections. J Antimicrob Chemother. 1992 Apr;29 (Suppl A):19–24. [PubMed]
  • Tambyah PA, Halvorson KT, Maki DG. A prospective study of pathogenesis of catheter-associated urinary tract infections. Mayo Clin Proc. 1999 Feb;74(2):131–136. [PubMed]
  • Daifuku R, Stamm WE. Association of rectal and urethral colonization with urinary tract infection in patients with indwelling catheters. JAMA. 1984 Oct 19;252(15):2028–2030. [PubMed]
  • Garibaldi RA, Burke JP, Britt MR, Miller MA, Smith CB. Meatal colonization and catheter-associated bacteriuria. N Engl J Med. 1980 Aug 7;303(6):316–318. [PubMed]
  • Nickel JC, Costerton JW, McLean RJ, Olson M. Bacterial biofilms: influence on the pathogenesis, diagnosis and treatment of urinary tract infections. J Antimicrob Chemother. 1994 May;33 (Suppl A):31–41. [PubMed]
  • Darouiche RO, Smith JA, Jr, Hanna H, Dhabuwala CB, Steiner MS, Babaian RJ, Boone TB, Scardino PT, Thornby JI, Raad II. Efficacy of antimicrobial-impregnated bladder catheters in reducing catheter-associated bacteriuria: a prospective, randomized, multicenter clinical trial. Urology. 1999 Dec;54(6):976–981. [PubMed]
  • Lundeberg T. Prevention of catheter-associated urinary-tract infections by use of silver-impregnated catheters. Lancet. 1986 Nov 1;2(8514):1031–1031. [PubMed]
  • Liedberg H, Lundeberg T. Silver alloy coated catheters reduce catheter-associated bacteriuria. Br J Urol. 1990 Apr;65(4):379–381. [PubMed]
  • Liedberg H, Lundeberg T, Ekman P. Refinements in the coating of urethral catheters reduces the incidence of catheter-associated bacteriuria. An experimental and clinical study. Eur Urol. 1990;17(3):236–240. [PubMed]
  • Platt R, Polk BF, Murdock B, Rosner B. Risk factors for nosocomial urinary tract infection. Am J Epidemiol. 1986 Dec;124(6):977–985. [PubMed]
  • Johnson JR, Roberts PL, Olsen RJ, Moyer KA, Stamm WE. Prevention of catheter-associated urinary tract infection with a silver oxide-coated urinary catheter: clinical and microbiologic correlates. J Infect Dis. 1990 Nov;162(5):1145–1150. [PubMed]
  • Riley DK, Classen DC, Stevens LE, Burke JP. A large randomized clinical trial of a silver-impregnated urinary catheter: lack of efficacy and staphylococcal superinfection. Am J Med. 1995 Apr;98(4):349–356. [PubMed]
  • Rabkin DG, Stifelman MD, Birkhoff J, Richardson KA, Cohen D, Nowygrod R, Benvenisty AI, Hardy MA. Early catheter removal decreases incidence of urinary tract infections in renal transplant recipients. Transplant Proc. 1998 Dec;30(8):4314–4316. [PubMed]
  • Shapiro J, Hoffmann J, Jersky J. A comparison of suprapubic and transurethral drainage for postoperative urinary retention in general surgical patients. Acta Chir Scand. 1982;148(4):323–327. [PubMed]
  • Warren JW. Urethral catheters, condom catheters, and nosocomial urinary tract infections. Infect Control Hosp Epidemiol. 1996 Apr;17(4):212–214. [PubMed]
  • Maki DG, Hennekens CH, Bennett JV. Prevention of catheter-associated urinary tract infection. An additional measure. JAMA. 1972 Sep 11;221(11):1270–1271. [PubMed]
  • van der Wall E, Verkooyen RP, Mintjes-de Groot J, Oostinga J, van Dijk A, Hustinx WN, Verbrugh HA. Prophylactic ciprofloxacin for catheter-associated urinary-tract infection. Lancet. 1992 Apr 18;339(8799):946–951. [PubMed]
  • Maki DG. Risk factors for nosocomial infection in intensive care. 'Devices vs nature' and goals for the next decade. Arch Intern Med. 1989 Jan;149(1):30–35. [PubMed]
  • Warren JW, Platt R, Thomas RJ, Rosner B, Kass EH. Antibiotic irrigation and catheter-associated urinary-tract infections. N Engl J Med. 1978 Sep 14;299(11):570–573. [PubMed]
  • Platt R, Polk BF, Murdock B, Rosner B. Reduction of mortality associated with nosocomial urinary tract infection. Lancet. 1983 Apr 23;1(8330):893–897. [PubMed]
  • Huth TS, Burke JP, Larsen RA, Classen DC, Stevens LE. Clinical trial of junction seals for the prevention of urinary catheter-associated bacteriuria. Arch Intern Med. 1992 Apr;152(4):807–812. [PubMed]
  • Classen DC, Larsen RA, Burke JP, Stevens LE. Prevention of catheter-associated bacteriuria: clinical trial of methods to block three known pathways of infection. Am J Infect Control. 1991 Jun;19(3):136–142. [PubMed]
  • Saint S, Elmore JG, Sullivan SD, Emerson SS, Koepsell TD. The efficacy of silver alloy-coated urinary catheters in preventing urinary tract infection: a meta-analysis. Am J Med. 1998 Sep;105(3):236–241. [PubMed]
  • Maki DG, Stolz SM, Wheeler S, Mermel LA. Prevention of central venous catheter-related bloodstream infection by use of an antiseptic-impregnated catheter. A randomized, controlled trial. Ann Intern Med. 1997 Aug 15;127(4):257–266. [PubMed]
  • Nissenkorn I. The intraurethral catheter--three years of experience. Eur Urol. 1993;24(1):27–30. [PubMed]
  • Johnson DE, O'Reilly JL, Warren JW. Clinical evaluation of an external urine collection device for nonambulatory incontinent women. J Urol. 1989 Mar;141(3):535–537. [PubMed]

Articles from Emerging Infectious Diseases are provided here courtesy of Centers for Disease Control and Prevention

Formats:

Related citations in PubMed

See reviews...See all...

Cited by other articles in PMC

See all...

Links

  • Cited in Books
    Cited in Books
    PubMed Central articles cited in books
  • MedGen
    MedGen
    Related information in MedGen
  • PubMed
    PubMed
    PubMed citations for these articles

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...