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Arch Hellen Med, 26(6), November-December 2009, 741-750


Catheter-associated urinary tract infections: Pathogenesis and prevention

Department of Urology, General Hospital of Kalamata, Kalamata, Greece

Bladder catheterization is the most common risk factor for development of nosocomial infections and Gram negative bacteremia. Virtually all catheterized patients will present with bacteriuria within a month of catheterization. Complications of long term bladder catheterization include pyelonephritis, obstruction, lithiasis and perigenital infections. In women the predominant route of introduction of bacteria is via the external surface of the catheter, while in males the main route is through the lumen of the catheter and the drainage bag. The most important predisposing factors in the development of bacteriuria are the duration of catheterization, female gender, age, serious co-morbidities and renal dysfunction. urinary tract infections can be prevented if catheterization indications are followed, aseptic technique is maintained during insertion of the catheter, and closed urine collection systems are used. Alternative methods of urine drainage such as suprapubic catheterization, condom type catheters and intermittent catheterization should be considered when indicated. The role of chemoprophylaxis remains uncertain.

Key words: Catheter, Pathogenesis, Prevention, Urinary tract infection.

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