DÄ internationalArchive6/2020Catheter-associated urinary tract infections in adult patients

Original article

Catheter-associated urinary tract infections in adult patients

Preventive strategies and treatment options

Dtsch Arztebl Int 2020; 117: 83-8. DOI: 10.3238/arztebl.2020.0083

Kranz, J; Schmidt, S; Wagenlehner, F; Schneidewind, L

For technical reasons, the English full text will be published approximately two weeks after the German print edition has been published.

*Die Autorinnen teilen sich die Erstautorenschaft.
Klinik für Urologie und Kinderurologie, St. Antonius-Hospital gGmbH, Akademisches Lehrkrankenhaus der RWTH Aachen, Eschweiler:
PD Dr. med. Jennifer Kranz
UroEvidence, Deutsche Gesellschaft für Urologie, Berlin:
PD Dr. med. Jennifer Kranz, Stefanie Schmidt, PhD, MPH;
Dr. med. Laila Schneidewind
Universitätsklinik und Poliklinik für Urologie, Universitätsklinikum Halle (Saale):
PD Dr. med. Jennifer Kranz
Klinik und Poliklinik für Urologie, Kinderurologie und Andrologie,
Universitätsklinikum Gießen und Marburg GmbH, Justus-Liebig-Universität Gießen:
Prof. Dr. med. Florian Wagenlehner
Klinik und Poliklinik für Urologie, Universitätsmedizin Rostock:
Dr. med. Laila Schneidewind
1. Warren JW, Platt R, Thomas RJ, Rosner B, Kass EH: Antibiotic irrigation and catheter-associated urinary-tract infections. N Engl J Med 1978; 299: 570–3 CrossRef MEDLINE
2. Nationales Referenzzentrum für Surveillance von nosokomialen Infektionen: Deutsche nationale Punkt-Prävalenzerhebung zu nosokomialen Infektionen und Antibiotika-Anwendung. 2016 Abschlussbericht. www.nrz-hygiene.de/fileadmin/nrz/download/pps2016/PPS_2016_Abschlussbericht_20.07.2017.pdf (last accessed on 14 January 2020).
3. Saint S, Chenoweth CE: Biofilms and catheter-associated urinary tract infections. Infect Dis Clin North Am 2003; 17: 411–32 CrossRef
4.Warren JW: Catheter-associated urinary tract infections. Int J Antimicrob Agents 2001; 17: 299–303 CrossRef
5.Bagshaw SM, Laupland KB: Epidemiology of intensive care unit-acquired urinary tract infections. Curr Opin Infect Dis 2006; 19: 67–71 CrossRef MEDLINE
6.Wagenlehner FM, Loibl E, Vogel H, Naber KG: Incidence of nosocomial urinary tract infections on a surgical intensive care unit and implications for management. Int J Antimicrob Agents 2006; 28 Suppl 1: S86–90 CrossRef MEDLINE
7.Nationales Referenzzentrum für Surveillance von nosokomialen Infektionen: KISS Krankenhaus-Infektions-Surveillance-System, Infektionssurveillance im Modul ITS-KISS Referenzdaten. www.nrz-hygiene.de/fileadmin/nrz/module/its/201001_201412_ALLE_ITSRef.pdf (last accessed on 14 January 2020).
8.Warren JW, Damron D, Tenney JH, Hoopes JM, Deforge B, Muncie HL Jr.: Fever, bacteremia, and death as complications of bacteriuria in women with long-term urethral catheters. J Infect Dis 1987; 155: 1151–8 CrossRef MEDLINE
9.Garibaldi RA, Burke JP, Dickman ML, Smith CB: Factors predisposing to bacteriuria during indwelling urethral catheterization. N Engl J Med 1974; 291: 215–9 CrossRef MEDLINE
10.Hartstein AI, Garber SB, Ward TT, Jones SR, Morthland VH: Nosocomial urinary tract infection: a prospective evaluation of 108 catheterized patients. Infect Control 1981; 2: 380–6 CrossRef MEDLINE
11.Bryan CS, Reynolds KL: Hospital-acquired bacteremic urinary tract infection: epidemiology and outcome. J Urol 1984; 132: 494–8 CrossRef
12.Gould CV, Umscheid CA, Agarwal RK, Kuntz G, Pegues DA: Guideline for prevention of catheter-associated urinary tract infections 2009. Infect Control Hosp Epidemiol 2010; 31: 319–26 CrossRef MEDLINE
13.Weinstein MP, Towns ML, Quartey SM, et al.: The clinical significance of positive blood cultures in the 1990s: a prospective comprehensive evaluation of the microbiology, epidemiology, and outcome of bacteremia and fungemia in adults. Clin Infect Dis 1997; 24: 584–602 CrossRef MEDLINE
14. Kranz J, Schmidt S, Lebert C, Schneidewind L, Schmiemann G, Wagenlehner F: Uncomplicated bacterial community-acquired urinary tract infection in adults. Dtsch Arztebl Int 2017; 114: 866–73 CrossRef MEDLINE PubMed Central
15.Zowawi HM, Harris PN, Roberts MJ, et al.: The emerging threat of multidrug-resistant gram-negative bacteria in urology. Nat Rev Urol 2015; 12: 570–84 CrossRef MEDLINE
16. Haby MM, Chapman E, Clark R, Barreto J, Reveiz L, Lavis JN: What are the best methodologies for rapid reviews of the research evidence for evidence-informed decision making in health policy and practice: a rapid review. Health Res Policy Syst 2016; 14: 83 CrossRef MEDLINE PubMed Central
17.Li L, Wen J, Wang L, Li YP, Li Y: Is routine indwelling catheterisation of the bladder for caesarean section necessary? A systematic review. BJOG 2011; 118: 400–9 CrossRef MEDLINE
18.Ahmed MR, Sayed Ahmed WA, Atwa KA, Metwally L: Timing of urinary catheter removal after uncomplicated total abdominal hysterectomy: a prospective randomized trial. Eur J Obstet Gynecol Reprod Biol 2014; 176: 60–3 CrossRef MEDLINE
19.Alessandri F, Mistrangelo E, Lijoi D, Ferrero S, Ragni N: A prospective, randomized trial comparing immediate versus delayed catheter removal following hysterectomy. Acta Obstet Gynecol Scand 2006; 85: 716–20 CrossRef MEDLINE
20.Bray R, Cartwright R, Digesu A, Fernando R, Khullar V: A randomised controlled trial comparing immediate versus delayed catheter removal following vaginal prolapse surgery. Eur J Obstet Gynecol Reprod Biol 2017; 210: 314–8 CrossRef MEDLINE
21. Chai J, Pun TC: A prospective randomized trial to compare immediate and 24-hour delayed catheter removal following total abdominal hysterectomy. Acta Obstet Gynecol Scand 2011; 90: 478–82 CrossRef MEDLINE
22.Dunn TS, Shlay J, Forshner D: Are in-dwelling catheters necessary for 24 hours after hysterectomy? Am J Obstet Gynecol 2003; 189: 435–7 CrossRef
23. El-Mazny A, El-Sharkawy M, Hassan A: A prospective randomized clinical trial comparing immediate versus delayed removal of urinary catheter following elective cesarean section. Eur J Obstet Gynecol Reprod Biol 2014; 181: 111–4 CrossRef MEDLINE
24.Hakvoort RA, Elberink R, Vollebregt A, Ploeg T, Emanuel MH: How long should urinary bladder catheterisation be continued after vaginal prolapse surgery? A randomised controlled trial comparing short term versus long term catheterisation after vaginal prolapse surgery. BJOG 2004; 111: 828–30 CrossRef MEDLINE
25. Sekhavat L, Farajkhoda T, Davar R: The effect of early removal of indwelling urinary catheter on postoperative urinary complications in anterior colporrhaphy surgery. Aust N Z J Obstet Gynaecol 2008; 48: 348–52 CrossRef MEDLINE
26. Weemhoff M, Wassen MM, Korsten L, Serroyen J, Kampschoer PH, Roumen FJ: Postoperative catheterization after anterior colporrhaphy: 2 versus 5 days. A multicentre randomized controlled trial. Int Urogynecol J 2011; 22: 477–83 CrossRef MEDLINE PubMed Central
27.Cai T, Caola I, Tessarolo F, et al.: Solidago, orthosiphon, birch and cranberry extracts can decrease microbial colonization and biofilm development in indwelling urinary catheter: a microbiologic and ultrastructural pilot study. World J Urol 2014; 32: 1007–14 CrossRef MEDLINE
28.Fernandez RS, Griffiths RD: Duration of short-term indwelling catheters—a systematic review of the evidence. J Wound Ostomy Continence Nurs 2006; 33: 145–53 CrossRef MEDLINE
29. Cooper FP, Alexander CE, Sinha S, Omar MI: Policies for replacing long-term indwelling urinary catheters in adults. Cochrane Database Syst Rev 2016; 7: CD011115 CrossRef MEDLINE
30.Phipps S, Lim YN, McClinton S, Barry C, Rane A, N‘Dow J: Short term urinary catheter policies following urogenital surgery in adults. Cochrane Database Syst Rev 2006: CD004374 CrossRef MEDLINE
31.Iorio R, Healy WL, Patch DA, Appleby D: The role of bladder catheterization in total knee arthroplasty. Clin Orthop Relat Res 2000: 80–4 CrossRef MEDLINE
32. Baan AH, Vermeulen H, van der Meulen J, Bossuyt P, Olszyna D, Gouma DJ: The effect of suprapubic catheterization versus transurethral catheterization after abdominal surgery on urinary tract infection: a randomized controlled trial. Dig Surg 2003; 20: 290–5 CrossRef MEDLINE
33.Dixon L, Dolan LM, Brown K, Hilton P: RCT of urethral versus suprapubic catheterization. Br J Nurs 2010; 19: S7–13 CrossRef MEDLINE
34.Stekkinger E, van der Linden PJ: A comparison of suprapubic and transurethral catheterization on postoperative urinary retention after vaginal prolapse repair: a randomized controlled trial. Gynecol Obstet Invest 2011; 72: 109–16 CrossRef MEDLINE
35. Healy EF, Walsh CA, Cotter AM, Walsh SR: Suprapubic compared with transurethral bladder catheterization for gynecologic surgery: a systematic review and meta-analysis. Obstet Gynecol 2012; 120: 678–87 CrossRef MEDLINE
36.Hunter KF, Bharmal A, Moore KN: Long-term bladder drainage: Suprapubic catheter versus other methods: a scoping review. Neurourol Urodyn 2013; 32: 944–51 CrossRef MEDLINE
37.Kidd EA, Stewart F, Kassis NC, Hom E, Omar MI: Urethral (indwelling or intermittent) or suprapubic routes for short-term catheterisation in hospitalised adults. Cochrane Database Syst Rev 2015; 10: CD004203 CrossRef MEDLINE
38.Hakvoort RA, Thijs SD, Bouwmeester FW, et al.: Comparing clean intermittent catheterisation and transurethral indwelling catheterisation for incomplete voiding after vaginal prolapse surgery: a multicentre randomised trial. BJOG 2011; 118: 1055–60 CrossRef CrossRef MEDLINE
39. Hälleberg Nyman M, Gustafsson M, Langius-Eklof A, Johansson JE, Norlin R, Hagberg L: Intermittent versus indwelling urinary catheterisation in hip surgery patients: a randomised controlled trial with cost-effectiveness analysis. Int J Nurs Stud 2013; 50: 1589–98 CrossRef MEDLINE
e1.Zhang W, Liu A, Hu D, et al.: Indwelling versus intermittent urinary catheterization following total joint arthroplasty: A systematic review and meta-analysis. PLoS ONE 2015; 10: e0130636 CrossRef MEDLINE PubMed Central
e2.Gong Y, Zhao L, Wang L, Wang F: The effect of clamping the indwelling urinary catheter before removal in cervical cancer patients after radical hysterectomy. J Clin Nurs 2017; 26: 1131–6 CrossRef MEDLINE
e3.Fernandez RS, Griffiths RD: Clamping short-term indwelling catheters: a systematic review of the evidence. J Wound Ostomy Continence Nurs 2005; 32: 329–36 CrossRef MEDLINE
e4.Wang LH, Tsai MF, Han CS, Huang YC, Liu HE: Is bladder training by clamping before removal necessary for short-term indwelling urinary catheter inpatient? A systematic review and meta-analysis. Asian Nurs Res 2016; 10: 173–81 CrossRef MEDLINE
e5.Shepherd AJ, Mackay WG, Hagen S: Washout policies in long-term indwelling urinary catheterisation in adults. Cochrane Database Syst Reviews 2017; 3: CD004012 CrossRef PubMed Central
e6.Darouiche RO, Goetz L, Kaldis T, Cerra-Stewart C, AlSharif A, Priebe M: Impact of StatLock securing device on symptomatic catheter-related urinary tract infection: a prospective, randomized, multicenter clinical trial. Am J Infect Control 2006; 34: 555–60 CrossRef MEDLINE
e7. van den Eijkel E, Griffiths P: Catheter valves for indwelling urinary catheters: a systematic review. Br J Community Nurs 2006; 11: 111–2, 114 CrossRef MEDLINE
e8.Al-Habdan I, Sadat-Ali M, Corea JR, Al-Othman A, Kamal BA, Shriyan DS: Assessment of nosocomial urinary tract infections in orthopaedic patients: a prospective and comparative study using two different catheters. Int Surg 2003; 88: 152–4.
e9.Dieter AA, Amundsen CL, Edenfield AL, et al.: Oral antibiotics to prevent postoperative urinary tract infection: a randomized controlled trial. Obstet Gynecol 2014; 123: 96–103 CrossRef MEDLINE
e10.Pfefferkorn U, Lea S, Moldenhauer J, Peterli R, von Flue M, Ackermann C: Antibiotic prophylaxis at urinary catheter removal prevents urinary tract infections: a prospective randomized trial. Ann Surg 2009; 249: 573–5 CrossRef MEDLINE
e11. Rogers RG, Kammerer-Doak D, Olsen A, et al.: A randomized, double-blind, placebo-controlled comparison of the effect of nitrofurantoin monohydrate macrocrystals on the development of urinary tract infections after surgery for pelvic organ prolapse and/or stress urinary incontinence with suprapubic catheterization. Am J Obstet Gynecol 2004; 191: 182–7 CrossRef MEDLINE
e12.Pickard R, Lam T, Maclennan G, et al.: Types of urethral catheter for reducing symptomatic urinary tract infections in hospitalised adults requiring short-term catheterisation: multicentre randomised controlled trial and economic evaluation of antimicrobial- and antiseptic-impregnated urethral catheters (the CATHETER trial). Health Technol Assess 2012; 16: 1–197 CrossRef MEDLINE
e13.Marschall J, Carpenter CR, Fowler S, Trautner BW, CDCPE Program: Antibiotic prophylaxis for urinary tract infections after removal of urinary catheter: meta-analysis. BMJ 2013; 346: f3147 CrossRef MEDLINE PubMed Central
e14.Brosnahan J, Jull A, Tracy C: Types of urethral catheters for management of short-term voiding problems in hospitalised adults. Cochrane Database Syst Rev 2004; 1 : CD004013 CrossRef
e15.Lam TB, Omar MI, Fisher E, Gillies K, MacLennan S: Types of indwelling urethral catheters for short-term catheterisation in hospitalised adults. Cochrane Database Syst Rev 2014; 9: CD004013 CrossRef MEDLINE
e16.Lusardi G, Lipp A, Shaw C: Antibiotic prophylaxis for short-term catheter bladder drainage in adults. Cochrane Database Syst Rev 2013; 7: CD005428 CrossRef
e17.Niël-Weise BS, van den Broek PJ: Antibiotic policies for short-term catheter bladder drainage in adults. Cochrane Database Syst Rev 2005; 3: CD005428 CrossRef
e18. van Hees BC, Vijverberg PL, Hoorntje LE, Wiltink EH, Go PM, Tersmette M: Single-dose antibiotic prophylaxis for urinary catheter removal does not reduce the risk of urinary tract infection in surgical patients: a randomized double-blind placebo-controlled trial. Clin Microbiol Infect 2011; 17: 1091–4 CrossRef MEDLINE
e19.Bonfill X, Rigau D, Esteban-Fuertes M, et al.: Efficacy and safety of urinary catheters with silver alloy coating in patients with spinal cord injury: a multicentric pragmatic randomized controlled trial. The ESCALE trial. Spine J 2017; 17: 1650–7 CrossRef MEDLINE
e20. Jahn P, Beutner K, Langer G: Types of indwelling urinary catheters for long-term bladder drainage in adults. Cochrane Database Syst Rev 2012; 10: CD004997 CrossRef MEDLINE
e21. Cao Y, Gong Z, Shan J, Gao Y: Comparison of the preventive effect of urethral cleaning versus disinfection for catheter-associated urinary tract infections in adults: A network meta-analysis. Int J Infect Dis 2018; 76: 102–8 CrossRef MEDLINE
e22.Ercole FF, Macieira TG, Wenceslau LC, Martins AR, Campos CC, Chianca TC: Integrative review: evidences on the practice of intermittent/indwelling urinary catheterization. Rev Lat Am Enfermagem 2013; 21: 459–68 CrossRef MEDLINE
e23.Gunnarsson AK, Gunningberg L, Larsson S, Jonsson KB: Cranberry juice concentrate does not significantly decrease the incidence of acquired bacteriuria in female hip fracture patients receiving urine catheter: a double-blind randomized trial. Clin Interv Aging 2017; 12: 137–43 CrossRef MEDLINE PubMed Central
e24.Foxman B, Cronenwett AE, Spino C, Berger MB, Morgan DM: Cranberry juice capsules and urinary tract infection after surgery: results of a randomized trial. Am J Obstet Gynecol 2015; 213: 194.e1–8 CrossRef MEDLINE PubMed Central
e25.Chen YY, Chi MM, Chen YC, Chan YJ, Chou SS, Wang FD: Using a criteria-based reminder to reduce use of indwelling urinary catheters and decrease urinary tract infections. Am J Crit Care 2013; 22: 105–14 CrossRef MEDLINE
e26.Loeb M, Hunt D, O‘Halloran K, Carusone SC, Dafoe N, Walter SD: Stop orders to reduce inappropriate urinary catheterization in hospitalized patients: a randomized controlled trial. J Gen Intern Med 2008; 23: 816–20 CrossRef MEDLINE MEDLINE
e27.Mody L, Krein SL, Saint S, et al.: A targeted infection prevention intervention in nursing home residents with indwelling devices: a randomized clinical trial. JAMA Intern Med 2015; 175: 714–23 CrossRef MEDLINE PubMed Central
e28.Wilde MH, McMahon JM, McDonald MV, et al.: Self-management intervention for long-term indwelling urinary catheter users: randomized clinical trial. Nurs Res 2015; 64: 24–34 CrossRef MEDLINE PubMed Central
e29.Durant DJ: Nurse-driven protocols and the prevention of catheter-associated urinary tract infections: a systematic review. Am J Infect Control 2017; 45: 1331–41 CrossRef MEDLINE
e30. Gould D, Gaze S, Drey N, Cooper T: Implementing clinical guidelines to prevent catheter-associated urinary tract infections and improve catheter care in nursing homes: systematic review. Am J Infect Control 2017; 45: 471–6 CrossRef MEDLINE
e31.Meddings J, Rogers MA, Macy M, Saint S: Systematic review and meta-analysis: reminder systems to reduce catheter-associated urinary tract infections and urinary catheter use in hospitalized patients. Clin Infect Dis 2010; 51: 550–60 CrossRef MEDLINE
e32.Meddings J, Saint S, Krein SL, et al.: Systematic review of interventions to reduce urinary tract infection in nursing home residents. J Hosp Med 2017; 12: 356–68 CrossRef MEDLINE PubMed Central
e33.Kringel U, Reimer T, Tomczak S, Green S, Kundt G, Gerber B: Postoperative infections due to bladder catheters after anterior colporrhaphy: a prospective, randomized three-arm study. Int Urogynecol J 2010; 21: 1499–504 CrossRef MEDLINE
e34. Saint S: Clinical and economic consequences of nosocomial catheter-related bacteriuria. Am J Infect Control 2000; 28: 68–75 CrossRef
e35.Fakih MG, Pena ME, Shemes S, et al.: Effect of establishing guidelines on appropriate urinary catheter placement. Acad Emerg Med 2010; 17: 337–40 CrossRef MEDLINE
e36.Umscheid CA, Mitchell MD, Doshi JA, Agarwal R, Williams K, Brennan PJ: Estimating the proportion of healthcare-associated infections that are reasonably preventable and the related mortality and costs. Infect Control Hosp Epidemiol 2011; 32: 101–14 CrossRef MEDLINE
e37.Moher D, Liberati A, Tetzlaff J, Altman DG, The PRISMA Group: Preferred reporting items for systematic reviews and meta-analyses: The PRISMA Statement. PLoS Med 2009; 6: e1000097 CrossRef MEDLINE PubMed Central