Microbiological and microstructural analysis of indwelling bladder catheters and urinary tract infection prevention.
Mateus Flávio Sousa, Luís Guilherme Oliveira Reis, Valéria da Silva Baracho and 3 others
PMID 35377389WHAT IT FOUND
In 42 catheterized patients, 15 removed catheter tips had mature biofilms, and magnesium-ammonium-phosphate crystals appeared in urine samples with high bacterial counts.
Antibiotic use was associated with high-count cultures, but no prevention strategy was tested.
Key findings
01Of 42 catheter tips analyzed, 15 (35.71%) showed mature biofilm, and all these patients had suprapubic sensitivity and costovertebral angle pain soon after removal.
02In 14 (33.3%) urine samples, magnesium-ammonium-phosphate crystals were seen, and all samples with that crystal had urine and catheter tip culture values at least 10^5 CFU/mL.
03Antibiotic use was associated with urine culture >10^5 CFU/mL.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The sample was a convenience sample of 42 patients from one institution, so the findings may not apply to other settings. Patients who were unconscious or had neurogenic bladder, urethral stenosis, urinary incontinence, bladder dysfunction or prostate hyperplasia were excluded, so it says little about those groups. Urine culture results were available in medical records for only 8 patients, and signs and symptoms of UTI were not described for those records. Some patients had already started antibiotics before the recorded date, which can reduce bacterial growth and produce false-negative cultures. The study was observational and did not test a catheter-care intervention, so associations cannot show that any practice prevented infection.
The easy way to misread this
Do not read the association between antibiotic use and urine culture >10^5 CFU/mL as evidence that antibiotics prevent catheter-associated UTI. This was an observational study without a control intervention, and the paper did not test whether antibiotics reduced infection.