TY - JOUR
T1 - Catheter-associated urinary tract infections in intensive care units
AU - Leone, Marc
AU - Garnier, Franck
AU - Avidan, Michael
AU - Martin, Claude
PY - 2004/9
Y1 - 2004/9
N2 - The purpose of this review is to analyze literature concerning the diagnosis, prevention, and management of catheter-associated urinary tract infection (CAUTI) occurring in patients hospitalized in the intensive care unit (ICU). Analysis was performed from personal and "Pubmed" data, crossing the following keywords: "urinary tract infection", "catheter', and "intensive care unit". Few clinical trials including ICU patients were found despite the abundance of expert opinions. There is no consensus on the use of urinary reagent tests for diagnosis. The prevention of CAUTI in ICU patients does not require expensive devices. Neither complex closed drainage systems nor silver-coated urinary catheters have demonstrated efficacy in comparative randomized clinical trials. Bladder irrigation should not be used, except when an obstruction of the catheter is highly likely. The administration of prophylactic antimicrobial therapy, although effective in reducing the incidence of urinary bacteria, cannot be recommended in ICU patients. The management of CAUTI in ICU patients has not been evaluated in clinical trials. The level of evidence provided in this field is weak, and underlines the need for randomized studies to improve management of patients.
AB - The purpose of this review is to analyze literature concerning the diagnosis, prevention, and management of catheter-associated urinary tract infection (CAUTI) occurring in patients hospitalized in the intensive care unit (ICU). Analysis was performed from personal and "Pubmed" data, crossing the following keywords: "urinary tract infection", "catheter', and "intensive care unit". Few clinical trials including ICU patients were found despite the abundance of expert opinions. There is no consensus on the use of urinary reagent tests for diagnosis. The prevention of CAUTI in ICU patients does not require expensive devices. Neither complex closed drainage systems nor silver-coated urinary catheters have demonstrated efficacy in comparative randomized clinical trials. Bladder irrigation should not be used, except when an obstruction of the catheter is highly likely. The administration of prophylactic antimicrobial therapy, although effective in reducing the incidence of urinary bacteria, cannot be recommended in ICU patients. The management of CAUTI in ICU patients has not been evaluated in clinical trials. The level of evidence provided in this field is weak, and underlines the need for randomized studies to improve management of patients.
KW - Bacteriuria
KW - Catheterization
KW - Diagnosis
KW - Intensive care unit
KW - Management
KW - Prevention
KW - Review
KW - Urinary tract infection
UR - http://www.scopus.com/inward/record.url?scp=4444358119&partnerID=8YFLogxK
U2 - 10.1016/j.micinf.2004.05.016
DO - 10.1016/j.micinf.2004.05.016
M3 - Short survey
C2 - 15345235
AN - SCOPUS:4444358119
SN - 1286-4579
VL - 6
SP - 1026
EP - 1032
JO - Microbes and Infection
JF - Microbes and Infection
IS - 11
ER -