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Diagnosing catheter-associated urinary tract infection: Still a matter of concern

Published:March 08, 2018DOI:https://doi.org/10.1016/j.ejim.2018.03.001
      Treatment of bacteriuria in the absence of symptoms is not indicated, taking into account the potential complications of therapy, including the increasing incidence of Clostridium difficile infection and the risk of precipitating antibiotic resistance [
      • Chenoweth C.
      • Gould C.V.
      • Saint S.
      Diagnosis, management, and prevention of catheter-associated urinary tract infections.
      ]. Previous studies among residents in chronic care facilities, have shown that antimicrobial initiation without meeting clinical criteria is common in patients with a suspected urinary tract infection [
      • Rotjanapan P.
      • Dosa D.
      • Thomas K.S.
      Potentially inappropriate treatment of urinary tract infections in two Rhode Island nursing homes.
      ]. The problem is even greater among patients with indwelling catheters because: 1) persons with a catheterized urinary tract acquire bacteriuria at the rate of 3–10% per day, when a closed drainage system is used [
      • Garibaldi R.A.
      • Burke J.P.
      • Dickman M.L.
      • Smith C.B.
      Factors predisposing to bacteriuria diuring indwelling urethral catheterization.
      ], and 2) the population at risk of receiving a catheter-associated urinary tract infection (CAUTI) diagnosis is likely to be cognitive impaired, which can mask possible associated symptoms.

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