A prospective study on the pathogenesis of catheter-associated bacteriuria in critically ill patients.
Catheter-associated bacteriuria
Critically ill patients
Pathogenesis
Journal
BMC microbiology
ISSN: 1471-2180
Titre abrégé: BMC Microbiol
Pays: England
ID NLM: 100966981
Informations de publication
Date de publication:
22 03 2021
22 03 2021
Historique:
received:
02
12
2020
accepted:
08
03
2021
entrez:
23
3
2021
pubmed:
24
3
2021
medline:
15
12
2021
Statut:
epublish
Résumé
Updating the pathogenesis of catheter-associated bacteriuria (CA-bacteriuria) in the intensive care unit (ICU) is needed to adapt prevention strategies. Our aim was to determine whether the main pathway of CA-bacteriuria in ICU patients was endoluminal or exoluminal. In a prospective study, quantitative urine cultures were sampled from catheter sampling sites, collector bags and the catheter outer surface near the meatus from days 1 to 15 after catheterization. The endoluminal pathway was CA-bacteriuria (defined as 10 Of 64 included patients, 20 had CA-bacteriuria. Means of catheterization days and incidence density were 6.81 days and 55.2/1000 catheter-days. Of 26 microorganisms identified, 12 (46.2%) were Gram positive cocci, 8 (30.8%) Gram negative bacilli and 6 yeasts. Three (11.5%) CA-bacteriuria were endoluminal and 23 (88.5%) exoluminal, of which 10 (38.5%) were early and 13 (50%) late. Molecular comparison confirmed culture findings. A quality audit showed good compliance with guidelines. The exoluminal pathway of CA-bacteriuria in ICU patients predominated and surprisingly occurred early despite good implementation of guidelines. This finding should be considered in guidelines for prevention of CA-bacteriuria.
Sections du résumé
BACKGROUND
Updating the pathogenesis of catheter-associated bacteriuria (CA-bacteriuria) in the intensive care unit (ICU) is needed to adapt prevention strategies. Our aim was to determine whether the main pathway of CA-bacteriuria in ICU patients was endoluminal or exoluminal. In a prospective study, quantitative urine cultures were sampled from catheter sampling sites, collector bags and the catheter outer surface near the meatus from days 1 to 15 after catheterization. The endoluminal pathway was CA-bacteriuria (defined as 10
RESULTS
Of 64 included patients, 20 had CA-bacteriuria. Means of catheterization days and incidence density were 6.81 days and 55.2/1000 catheter-days. Of 26 microorganisms identified, 12 (46.2%) were Gram positive cocci, 8 (30.8%) Gram negative bacilli and 6 yeasts. Three (11.5%) CA-bacteriuria were endoluminal and 23 (88.5%) exoluminal, of which 10 (38.5%) were early and 13 (50%) late. Molecular comparison confirmed culture findings. A quality audit showed good compliance with guidelines.
CONCLUSION
The exoluminal pathway of CA-bacteriuria in ICU patients predominated and surprisingly occurred early despite good implementation of guidelines. This finding should be considered in guidelines for prevention of CA-bacteriuria.
Identifiants
pubmed: 33752594
doi: 10.1186/s12866-021-02147-9
pii: 10.1186/s12866-021-02147-9
pmc: PMC7983228
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
86Références
Emerg Infect Dis. 2001 Mar-Apr;7(2):342-7
pubmed: 11294737
Clin Infect Dis. 2010 Mar 1;50(5):625-63
pubmed: 20175247
Urology. 1985 Oct;26(4):369-75
pubmed: 3931323
Am J Infect Control. 2018 Dec;46(12):e81-e90
pubmed: 30174256
N Engl J Med. 1957 Mar 21;256(12):556-7
pubmed: 13419041
N Engl J Med. 1980 Aug 7;303(6):316-8
pubmed: 6991947
Am J Surg. 1999 Apr;177(4):287-90
pubmed: 10326844
Antimicrob Agents Chemother. 2002 Apr;46(4):1128-31
pubmed: 11897606
J Hosp Infect. 1996 Feb;32(2):105-15
pubmed: 8666761
Infect Control Hosp Epidemiol. 2007 Dec;28(12):1367-73
pubmed: 17994517
J Clin Microbiol. 1995 Sep;33(9):2233-9
pubmed: 7494007
Eur J Clin Microbiol Infect Dis. 2001 Apr;20(4):260-2
pubmed: 11399016
Mayo Clin Proc. 1999 Feb;74(2):131-6
pubmed: 10069349
Am J Infect Control. 2015 Mar 1;43(3):206-21
pubmed: 25575913
Br J Urol. 1973 Dec;45(6):678-83
pubmed: 4204547
J Urol. 1972 Nov;108(5):719-21
pubmed: 5081705
JAMA. 1984 Oct 19;252(15):2028-30
pubmed: 6481909
Infect Control Hosp Epidemiol. 2014 May;35(5):464-79
pubmed: 24709715
Infect Control. 1981 Sep-Oct;2(5):380-6
pubmed: 6795141
J Urol. 1983 Dec;130(6):1096-9
pubmed: 6358531
Infect Control Hosp Epidemiol. 2010 Apr;31(4):319-26
pubmed: 20156062
N Engl J Med. 1974 Aug 1;291(5):215-9
pubmed: 4834750
J Med Eng Technol. 2015;39(8):459-70
pubmed: 26383168
Intensive Care Med. 2007 Apr;33(4):726-9
pubmed: 17294169