MICROBIOLOGICAL DIAGNOSIS OF URINARY CATHETER ASSOCIATED INFECTIONS- A topic of growing importance to both treating physicians and microbiologists, as we all know a catheter is a foreign substance can lead to changing dynamics of urinary bladder and urethra, A specimen for urine culture should be obtained before initiation of antibiotic therapy, because of the wide spectrum of potential infecting organisms and the increased likelihood of antimicrobial resistance is priority that the treating physician should write in requests that the reasons for cauterization and how long the catheter in place, and blind processing of the urine and reporting is counterproductive, as we teach our students as the signs and symptoms are different from a non-catheterized patients, Symptoms of catheter-related urinary tract infection (UTI) generally are nonspecific; most patients present with fever and leukocytes. Significant pyuria is generally represented by more than 50 white blood cells (WBCs) per high-power field (HPF). Colony counts on a urine culture range from 100-10,000/mL. If we read the culture plate from these patients much to our surprise the growth is poly microbial flora certainly we will miss many individual bacteria if we compromise inoculating many specimens on a single plate as many have resource crunch not to forget a full plate is an optimal area to identify the isolates with clarity, The 2009 Infectious Diseases Society of America (IDSA) guidelines define catheter-related UTI in patients whose urinary (urethral, supra pubic, or condom) catheter has been removed within the previous 48 hours by the presence of symptoms or signs compatible with UTI with no other identified source of infection along with 1000 or more colony-forming units (CFU)/mL of 1 or more bacterial species. Repeated poly microbial isolation should warrant for aseptic collection of the urine by trained paramedical staff this is true problem many do not care to send a specimen worth processing leading to prescription of antibiotic which are not warranted, and we will be treating all contamination as true infection
NEED FOR REPEATED CULTURING - If cauterization can be discontinued, the culture can be obtained in a voided midstream urine specimen A better understanding needed. If an indwelling catheter has been in place for longer than 2 weeks at the onset of the UTI and is still indicated, as happening with paralytic patients who have no control and many surgical interventions it should be replaced, and the urine culture should be obtained from the freshly placed catheter.
CAUTIs are one of the most common hospital-related infections. Therefore, many healthcare organizations place great emphasis on prevention. Catheter care in prevention of Hospital associated catheter infections
Healthcare providers clean their hands by washing them with soap and water or using an alcohol-based hand rub before and after touching catheter.
If you do not see your providers clean their hands, please ask them to do so.
NOT TO FORGET DIAGNOSING AND TREATING CATHETER ASSOCIATED INFECTIONS A GREAT CHALLENGE IN SPITE MANY ADVANCES IN PATIENT CARE
Ref Catheter-Related Urinary Tract Infection (UTI) Updated: Sep 08, 2017 Author: John L Brusch, MD, FACP;1 Chief Editor: Michael Stuart Bronze, MD
2 FAQs (frequently asked questions) “Catheter-Associated Urinary Tract Infection” IDSA AND CDC
Formulated by Dr.T.V.Rao MD for Infectious disease resource on worldwide web