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Managing Catheter-Associated Urinary Tract Infections

Catheter-associated bacteriuria, the most common healthcare-associated infection, results from the widespread use of urinary catheterization. Oftentimes, the use of urinary catheters is inappropriate in hospitals and long-term care facilities. “Considerable personnel time and other costs are expended by healthcare institutions throughout the world to reduce the rate of catheter-associated infections, especially those that occur in patients with urinary tract symptoms,” says Thomas M. Hooton, MD. Strategies to reduce the use of catheterization have been shown to be effective in published literature. The data demonstrate that use of such strategies is likely to have a significant impact on the incidence of catheter-associated urinary tract infections (CA-UTI). An expert panel of the Infectious Diseases Society of America (IDSA) released new guidelines that address CA-UTI in adults aged 18 and older. Published in the March 1, 2010 issue of Clinical Infectious Diseases, the guidelines are aimed at assisting physicians in all specialties who perform direct patient care, especially of patients in hospitals or long-term care facilities. “These evidence-based IDSA guidelines provide diagnostic criteria and strategies to reduce the risk of CA-UTIs,” explains Dr. Hooton, who was the lead author of the guidelines. “They also provide strategies that have not been found to reduce the incidence of urinary infections. Management strategies are presented to assist clinicians who treat patients with catheter-associated asymptomatic bacteriuria or symptomatic urinary tract infection. Implementing the strategies outlined in the guidelines should be a priority for all healthcare facilities.” Reducing the Incidence According to the guidelines, the most effective way to reduce the incidence of CA-UTI is to reduce the use of urinary catheterization (Table 1). This requires restricting...
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