The Use of Specific Catheters to Reduce the Risk of Catheter Associated Urinary Tract Infection

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Problem Statement

The urinary tract is usually sterile, however disturbance of the body’s natural defenses through surgical insertion of catheters introduces bacteria either intraluminally or extraluminally resulting to infection of the urinary tract. It is estimated that one out of four patients receiving hospitalized service has an indwelling urinary catheter for bladder drainage. Contraction of UTI is the most notable complication from these devices. For a long time, Urinary Tract Infections (UTI) has generated a lot of interest in medical practice and research. reported that UTIs are the leading cause of increased health expenditures and form basis for key policy issues.

The expenses are attributed to prolonged hospitalization and expenses due to lengthy diagnostic methods such as bacteria culturing. Among all hospital-acquired infections, UTI accounts for about 40% and increasing costs for health delivery by 25%. Catheter-associated UTIs accounts for over 40% or 1 million cases of all nosocomial infections in nursing homes and hospitals annually, the high incidence of this complication increases the overall cost of medication and untreated cases often leads to fatality. To reduce mortality and morbidity associated with urinary catheter infections, new approaches in prevention and treatment need to be designed. suggested that a more promising initiative is the anti-infective catheters. A review of literature may help us to answer question of whether anti-infective catheters helps in prevention of UTIs.

Literature Review

Use of indwelling catheter for long term is restrictive. However, According to Linda (2008) indwelling catheters have been used in long-term patient management. asserted that over 100,000 facilities in United States use indwelling catheters for long-term, and in UK, 4% of homecare elders are managed by indwelling catheters. Despite its benefits such as convenience use of catheters for long term management is indicated as the last option due to complication such as recurrent UTI and chronic colonization of the devices bacteria in indwelling managed patients. Urinary tract infection refers to inflammatory responses of the urinary tract epithelium to pathogenic (bacteria) invasion and colonization leading to bacteriuria and pyuria.

In the United States approximately $424 – $451million is spent annually on managing UTIs, this cost is anticipated to substantially, increase due to increased life expectancy. For example, aged population (> 65 years) represented 12.6% of the total US population in 2007. In the United Kingdom, the burden imposed to the National Health Service by because of catheter associated UTIs amounts to over £124 million annually. Recurrent and chronic cases of UTI and pyelonephritis have further complicates catheter-associated infection prognosis in patients.

Studies carried out a national survey to established efforts undertaken by hospitals in preventing catheter associated UTIs in USA. The authors targeted infection control coordinators from Veteran Affairs hospitals (n=119), and non-federal US hospitals having intensive care unit with capacity of over 50 beds (n=600). The participants were asked about initiatives undertaken at hospital level with aim of curbing spread of UTIs and other infections associated to medical devices. Specific questions requested respondents to rate on a scale of 1 to 5 how frequently certain catheter associated UTI practices were used on hospitalized adult patients. Participants were also asked about strategies employed in monitoring of urinary catheters and UTI at their facility. Additional questions related to whether the hospital had an epidemiologist or infection control coordinator. The study findings with response rate of 72% indicated that about 56% of hospitals had no monitoring systems for patients on urinary catheters, while about 74% never monitored duration of catheters in patients. Only 30% of the hospitals regularly reported...
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