Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2022 Jun 14;11(12):3415.
doi: 10.3390/jcm11123415.

How to Prevent Catheter-Associated Urinary Tract Infections: A Reappraisal of Vico's Theory-Is History Repeating Itself?

Stefania Musco  1 , Alessandro Giammò  2 , Francesco Savoca  3 , Luca Gemma  4   5 , Paolo Geretto  2 , Marco Soligo  6 , Emilio Sacco  7 , Giulio Del Popolo  1 , Vincenzo Li Marzi  4   5
Affiliations
Review

How to Prevent Catheter-Associated Urinary Tract Infections: A Reappraisal of Vico's Theory-Is History Repeating Itself?

Stefania Musco et al. J Clin Med. .

Abstract

New, contextualized modern solutions must be found to solve the dilemma of catheter-associated urinary infection (CAUTI) in long-term care settings. In this paper, we describe the etiology, risk factors, and complications of CAUTI, explore different preventive strategies proposed in literature from the past to the present, and offer new insights on therapeutic opportunities. A care bundle to prevent CAUTI mainly consists of multiple interventions to improve clinical indications, identifying a timeline for catheter removal, or whether any alternatives may be offered in elderly and frail patients suffering from chronic urinary retention and/or untreatable urinary incontinence. Among the various approaches used to prevent CAUTI, specific urinary catheter coatings according to their antifouling and/or biocidal properties have been widely investigated. Nonetheless, an ideal catheter offering holistic antimicrobial effectiveness is still far from being available. After pioneering research in favor of bladder irrigations or endovesical instillations was initially published more than 50 years ago, only recently has it been made clear that evidence supporting their use to treat symptomatic CAUTI and prevent complications is needed.

Keywords: CAUTI; endovesical instillation; geriatric incontinence; indwelling urinary catheter; long-term care; neurogenic bladder.

PubMed Disclaimer

Conflict of interest statement

Stefania Musco, Vincenzo Li Marzi, Alessandro Giammò, Francesco Savoca, Marco Soligo declared intellectual non-financial COI related to this work as member of the board of Directors of SIUD. Paolo Geretto, Luca Gemma, Giulio Del Popolo had financial support from SIUD directly related to the manuscript as consultant. Out of this work, the following COI have been declared: Stefania Musco with Ediermes, Helaglobe, Medice, Hollister Coloplast, Wellspect, Defoe; Vincenzo Li Marzi with Teleflex, Ediermes, Defoe; Alessandro Giammò with Innovamedica, DBI, Coloplast, Defoe; Francesco Savoca with Wellspect Giulio Del Popolo with Wellspect, BBraun, Coloplast, Hollister, Helaglobe, Farco-Pharma.

Figures

Figure 1
Figure 1
Catheter encrustations in 82-year-old male patient unfit for unobstructive prostatic surgery and chronically managed via indwelling silicone catheter (Tiemann tip).
Figure 2
Figure 2
Catheter’s lifecycle: (1) consider when and why catheter placement is necessary; (2) daily management and care when catheter is inserted; (3) before catheter reinsertion, consider whether it may be definitively removed; (4) reduce the need for long-term indwelling catheter management.
See this image and copyright information in PMC

References

    1. Magill S.S., Edwards J.R., Bamberg W., Beldavs Z.G., Dumyati G., Kainer M.A., Lynfield R., Maloney M., McAllister-Hollod L., Nadle J., et al. Emerging Infections Program Healthcare-Associated Infections and Antimicrobial Use Prevalence Survey Team. Multistate Point-Prevalence Survey of Health Care-Associated Infections. N. Engl. J. Med. 2014;370:1198–1208. doi: 10.1056/NEJMoa1306801. - DOI - PMC - PubMed
    1. Klevens R.M., Edwards J.R., Richards C.L., Jr., Horan T.C., Gaynes R.P., Pollock D.A., Cardo D.M. Estimating Healthcare-associated Infections and Deaths in U.S. Hospitals. Public Health Rep. 2007;122:160–166. doi: 10.1177/003335490712200205. - DOI - PMC - PubMed
    1. McGuckin M. The Patient Survival Guide: 8 Simple Solutions to Prevent Hospital- and Healthcare-Associated Infections. Springer Publishing Company; New York City, NY, USA: 2012.
    1. Lo E., Nicolle L.E., Coffin S.E., Gould C., Maragakis L.L., Meddings J., Pegues D.A., Pettis A.M., Saint S., Yokoe D.S. Strategies to prevent catheter-associated urinary tract infections in acute care hospitals: 2014 update. Infect. Control Hosp. Epidemiol. 2014;35:464–479. doi: 10.1086/675718. - DOI - PubMed
    1. Lo J., Lange D., Chew B. Ureteral Stents and Foley Catheters-Associated Urinary Tract Infections: The Role of Coatings and Materials in Infection Prevention. Antibiotics. 2014;3:87–97. doi: 10.3390/antibiotics3010087. - DOI - PMC - PubMed

LinkOut - more resources